Application Form NSF Research Experience for Undergraduates (REU) Program Application 2023 Step 1 of 7 - Personal Information 0% Personal InformationName* First Last Preferred Name* Preferred Pronouns* Email* Phone*Date of Birth (mm/dd/yyyy)* MM slash DD slash YYYY Citizenship*Are you a US Citizen or Permanent Resident? Yes No Permanent Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country College/University InformationCollege/university in which you are currently enrolled in* Dates of attendance (mm/yyyy)*From:To: Academic standing by June 1, 2023* Freshman Sophomore Junior Senior Major(s)* Minor(s) (if applicable) Expected graduation date (mm/yyyy)* MM slash DD slash YYYY Plans after graduation* Graduate School Medical/Dental School Employment Undecided Other Colleges AttendedCollege/university in which you were previously enrolled (if applicable) Dates of attendance (mm/yyyy)From:To: Transcript & GPAUnofficial Transcript*Max. file size: 100 MB.A transcript, including Fall 2022 grades, must accompany this application. Accepted file types: doc, docx, pdf. Cumulative GPA*Please enter a number greater than or equal to 0.Math/Science or Chemistry GPA*Please enter a number greater than or equal to 0. ResearchIf selected as a participant in our REU program, what areas of chemistry research are of interest to you? Please select from the drop-down menus the order of your choice (3 choices).First Choice*Analytical ChemistryBiological ChemistryInorganic Chemistry and MaterialsOrganic ChemistryPhysical ChemistryPolymer ChemistrySecond Choice*Analytical ChemistryBiological ChemistryInorganic Chemistry and MaterialsOrganic ChemistryPhysical ChemistryPolymer ChemistryThird Choice*Analytical ChemistryBiological ChemistryInorganic Chemistry and MaterialsOrganic ChemistryPhysical ChemistryPolymer ChemistryProjectsOur website lists project descriptions (under the Research Projects tab) that are representative of the projects you might participate in if you are selected. The project descriptions also include links to the faculty bio and research groups websites. After carefully reviewing the website, please list the names of three professors you would like to work with. Indicate your 1st, 2nd, and 3rd choice. Be sure to include their first and last name. Professor Name (First Choice)* Professor Name (Second Choice)* Professor Name (Third Choice)* Personal StatementWrite a short essay detailing your previous research experiences, personal and professional goals, and how you believe this REU program would assist in attaining them. Maximum length - 4000 characters, including spaces.Personal Statement*Accepted file types: doc, docx, pdf, Max. file size: 100 MB.Accepted file types: doc, docx, pdf. Letters of RecommendationPlease arrange for two letters of recommendation from those familiar with your academic work. Please provide your references' information below. Once you have submitted your application and provided us with your references' information, they will receive an email from UConn Chemistry REU with instructions on how to submit a letter of recommendation. Reference IName (First & Last)* Title* Institution* Email* Phone*Reference IIName (First & Last)* Title* Institution* Email* Phone* Optional Personal InformationThis information is requested for NSF statistical analysis. No personal information about you as an individual will be shared or affect your consideration for our REU program.Gender Identity: Which of the following most accurately describes you? Female Male Transgender Non-binary Non-conforming Prefer not to respond Other Race/Ethnicity American Indian or Alaska Native Asian Black or African American Hispanic or Latino White (not of Hispanic origin) Two or more races Prefer not to respond Other WaiverI hereby grant NSF-REU program permission to use the information I have provided here, with the proviso that none of this information about me will be accessible to anyone other than the qualified researchers performing the aggregation of information from all applicants and the statistical analysis of that aggregate data, and that these researchers will not report, disclose or publish any specific information about me individually. Your willingness to participate in this statistical survey will aid in the development of this federally funded program. However, your acceptance or rejection of this waiver will in no way affect consideration for admission to our REU program. Accept Reject SignatureHow did you learn about UConn Chemistry's REU program?* NSF REU website McNair Scholars Network LSAMP Scholars Network SACNAS UConn REU*May we, if appropriate, share your application with another campus or regional REU programs (Polymer chemistry, MCB, etc.?) Yes No Applicant Signature*By signing my name below, I certify the information I provided on and in connection with this form is true, accurate and complete. SignatureDate PhoneThis field is for validation purposes and should be left unchanged.