Nachtrieb application PDF - UIC Department of Chemistry

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
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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
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$ 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?
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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)
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______________
Date (MM/DD/YYYY)