UIC The University of Illinois at Chicago Chemistr y Aw ards Committee 2015 Norman Nachtrieb Award UIC Chemistry Scholarship Application The Norman Nachtrieb Award “for scientific promise” is given annually to one continuing sophomore, junior, or senior majoring in Chemistry (BA or BS) or in Teaching of Chemistry. The award carries a prize of $750. The student must have at least a 3.00 GPA and must turn in the completed application to the Department of Chemistry. The award is in memory of Norman Nachtrieb, a member of the UIC Chemistry faculty from 1986-1991. Norman Nachtrieb was a professor at the University of Chicago. After retiring there, he came to UIC and taught general chemistry for six years while collaborating with Wade Freeman on a textbook. THIS APPLICATION MUST BE TURNED IN TO THE DEPARTMENT OF CHEMISTRY FRONT OFFICE (4500 SES) NO LATER THAN 4:00PM ON FRIDAY, MARCH 20, 2015 For more information, please contact: Donald Wink / George Papadantonakis UIC Department of Chemistry Room 4500, Science & Engineering South (MC 111) 845 W Taylor St, Chicago, IL 60607 (312) 996-3161 [email protected] / [email protected] Name: ___________________________ __________________________ ____ UIN: ________________ (Last) (First) (Middle) Address: __________________________________ City: _________________ State: ____ Zip:_________ Cell Phone Number: _______________ Alternate Phone (if any): _________________ UIC E-mail Address: [email protected] Alternate E-Mail (if any): __________________________ Are you a U.S. Citizen? Select Gender: Select Ethnicity: _________________________ High School Attended: __________________________________ Date of Graduation __________ Academic Information Major (s) _______________BBBBBBB BBBBBBBBBBBBBBBBBBBBBB Current UIC Cumulative GPA in Chemistry _________ Hours completed at UIC _____________ Minor(s) BBBBBBBBBBBBBBBBBB _______________ Transfer GPA ____________ Transfer hours completed__________ Expected UIC Graduation Date ____________ Transfer Institution______________________________________ Are you a full time student? Select Honors College Member? Select 1 UIC The University of Illinois at Chicago Chemistr y Aw ards Committee Scholarships/Financial Aid – How do you currently pay for college/graduate school? (Please describe your current financial situation and describe any financial aid received.) -In the space below, write a brief statement describing your financial need. Be sure to include information on any extenuating circumstances not considered by the financial aid office. *Please provide us with a financial aid report if you receive financial aid from UIC. Honors/Awards: Please list all awards and honors and date received. Name of Award Date 2 $ Amount UIC The University of Illinois at Chicago Chemistr y Aw ards Committee Please answer the following questions to assist our committees to in understanding your academic, professional, and personal goals. You may use the space below or attach a separate sheet. Question 1: What are your academic/scholarly goals as a UIC student and beyond? Question 2: What profession do you intend to pursue and why? Question 3: How have your activities, experiences, and studies contributed to your future goals? 3 UIC The University of Illinois at Chicago Chemistr y Aw ards Committee Question 4: Have you participated in service activities/volunteer work within or around the UIC community and/or Chicagoland area? If so, how have these experiences influenced you? Question 5: Have you participated in research? If so, please describe it and explain how it has contributed to your education. Question 6: Have you faced hardship of challenges? If so, please describe your situation and how it has affected you. Please discuss what measures you have taken to manage or overcome it. Certification: I certify that all information on this application is correct and complete. I understand the information that I provide may be shared with members of an award selection committee. ______________________________________________ Signature (electronic signature NOT accepted) 4 ______________ Date (MM/DD/YYYY)
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