Application Form

Personal Information
Name*
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 Country

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College/University Information
College/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 Attended
College/university in which you were previously enrolled (if applicable)
Dates of attendance (mm/yyyy)
From: To:
Transcript & GPA
Unofficial 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.

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Research
If 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*
Second Choice*
Third Choice*
Projects
Our 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)*

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Personal Statement
Write 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.

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Letters of Recommendation
Please 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 I
Name (First & Last)*
Title*
Institution*
Email*
Phone*
Reference II
Name (First & Last)*
Title*
Institution*
Email*
Phone*

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Signature
How 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.
Signature Date
Phone
This field is for validation purposes and should be left unchanged.

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Chemistry REU Program

From:	To:

From:	To:

Signature	Date