Citrus ID #_____________________ Initials_______ Summer Research Experience Cover Sheet Name: _________________________________________________ Phone#____________________________ Last First MI Participants in the Summer Research Experience will gain a firsthand experience in scientific investigation in a dynamic, collaborative research environment. Students will get support from their partner institutions and will create a research poster which will be presented at one or more research symposiums. These experiences are paid and require a full-time commitment for 8 weeks. Please see basic program information below. Note that opportunities vary by institution. Please check any site(s) where you DO NOT wished to be placed. � Cal Poly Pomona Research labs include biochemistry, biology, chemistry, computer science, and engineering. Students placed at this site will begin June 23. � CSU Fullerton Research labs include biochemistry, biology, chemistry, computer science, fossils (curating), geology, mathematics, and engineering. Students placed at this site will begin June 16. � Rancho Santa Ana Botanic Garden Research will focus on botany and plant biology. Start date: TBD � Oak Crest Institute of Science, Pasadena Research areas include biology and chemistry with a medical or environmental focus. Start date: TBD � Jet Propulsion Laboratory Research in the planetary sciences. Start date: TBD � City of Hope Research will be in the areas of molecular and cellular biology. Start date: TBD □ Chapman University Research labs will be in the School of Earth and Environmental Sciences and related to earth and environmental issues from the molecular to global scale. Students placed at this site will have the option to receive on-campus housing and a meal plan. Students placed at this site will begin June 16. Summer Research Experience Selection Process All complete applications will be read and scored by two faculty/administrators. Top-scoring applicants will be invited for on-campus interviews beginning in mid-March and continuing through April. Citrus ID #_____________________ Initials_______ Summer Research Experience Application Check List To be eligible to apply you must be:      A US Citizen, Permanent Resident, or have approved Deferred Action status* Enrolled at Citrus College A member of the STEM Academy Planning to transfer in a STEM major Working towards your first bachelor’s degree    Finished with a minimum of two STEM classes (see chart in the application for details) by 6/14 Willing to make a full-time commitment to the program Available and committed to participating in the Fall 2014 Research Symposium at Citrus College. Students from groups traditionally underrepresented in STEM are especially encouraged to apply. Those most often considered underrepresented in STEM include: Hispanics, African-Americans, and Native Americans/Native Hawaiians/Pacific Islanders; Students from low-income backgrounds; Students who are part of the first generation in their family to attend college; Women; Persons with Disabilities; Foster Youth; and Veterans. *AB540 and International Students are eligible to apply but are ineligible to receive the stipend unless in possession of approved DA status and work permit. A complete application includes the following: □ □ □ □ □ □ □ □ Summer Research Experience Cover Sheet (with programs selected and signature) Summer Research Experience Application Check List (signed) Completed Summer Research Application Form Completed Personal Statement Form (prompt is the last page of application, please type your response) Your Citrus ID number and initials on each page of the application Unofficial transcripts from ALL colleges and universities attended A print out of your Financial Aid Award letter (can be printed out from wingspan) Two letters of recommendation submitted electronically by your instructors Note to applicants: This opportunity requires a full-time job commitment which may require work on the weekends. Please do not apply if you are planning to take any summer classes, travel or be out of town during the duration of the program. Please read the following statements and check the appropriate boxes. � I understand that Summer Research Experience is offered in collaboration with partner universities and institutions. I give my permission for the documents submitted as part of this application to be shared with partner campuses/sites to assist with placement. � I understand that Summer Research Experience is funded by federal grants that have an evaluation component. I give my permission for the documents submitted as part of this application to be shared with project evaluators. � I hereby certify to the best of my knowledge that all information submitted as a part of this application is complete and correct. I understand that failure to disclose accurate information is grounds for immediate termination from this program. _________________________________________________ Applicant’s Signature _______________________________ Date Please submit your complete application to Marianne Smith, Ph.D. (CI221) no later than 5:00 pm: Priority Deadline: February 24, 2014 Ѻ Regular Deadline: March 3, 2014 Citrus ID #_____________________ Initials_______ STEM SUMMER RESEARCH EXPERIENCE APPLICATION Contact Information Address: (a) Present_________________________________________________________________________ (b) Permanent ______________________________________________________________________ Permanent home phone number: (______) ________________ Cell phone number: (______) ______________ Citrus E-mail address: Alternate E-mail address: _________________________________________________________________ _________________________________________________________________ Academic Information Please indicate the year you obtained a high school � diploma________ � GED_________ �Other________ Last High School Attended: Name_________________________________ City________________________ List all colleges and universities you have attended: College Attended Start date End Date _____________________ _______ _______ _____________________ _______ _______ _____________________ _______ _______ Units completed Reason for leaving ___________ ___________ ___________ _____________________________ _____________________________ _____________________________ Citrus Major: __________________ Citrus GPA: ________ Expected Transfer Date: _______________ Did you apply for transfer in Fall 2014? � Yes � No If yes, what colleges or universities did you apply to? College/University Were you accepted? ______________________________________________ ______________________________________________ ______________________________________________ � Yes � No � Still waiting for notification � Yes � No � Still waiting for notification � Yes � No � Still waiting for notification If no, what colleges or universities are you interested in transferring to: 1st Choice______________________________________________________________________________ 2nd Choice______________________________________________________________________________ 3rd Choice_____________________________________________________________________________ Do you plan to attend graduate school (Masters and/or Ph.D.)? � Yes � No Do you plan to attend medical or other health professional school? � Yes � No If “yes” to any, please indicate field of interest __________________________________________________ Citrus ID #_____________________ Initials_______ Please fill in the charts below, indicate the STEM classes you have taken by writing your grade in the box next to each completed class. Classes taken at other colleges are also acceptable. Indicate those you are presently taking with a grade of IP=in progress. Don’t be concerned if you have only taken a couple of the courses listed below. Anthropology Physical Anthropology Physical Anthropology Lab Course # Anth 212 Anth 212 L Grade Astronomy Courses Planetary Astronomy Stellar Astronomy Life in the Universe Course # Astr 115 Astr 116 Astr 117 Grade Biology Courses Course # Grade Chemistry Courses Course # Grade Contemporary topic Bio 104 Beg. General Chem Chem 110 General Bio Bio 105 General Chem 1 Chem 111 Principals of Bio I Bio 124 General Chem 2 Chem 112 Principals of Bio II Bio 125 College Chem 1 Chem 103 Environmental Sci Bio 145 College Chem 2 Chem 104 Microbiology Bio 220 Organic Chem1 Chem 210 Anatomy Bio 200 Organic Chem 1L Chem 211L Physiology Bio 201 Organic Chem 2 Chem 220 Human Genetics Bio 102 Organic Chem 2L Chem 221L Computer Information Course # Computer Science Course # Grade Info. Systems & Applic. Electronic Spread Sheets Web Programing CSIS 107 CSIS 162 CSIS 119 Intro to Programing Object Oriented Programing Information Technology CS 111 CS 225 Course # Grade Microcomputer Appli. 1 Web Dev. Drm Weaver CSIS 130 CSIS 150 PC Hardware and Maint. Network Technology IT 104 IT 107 Microcomputer Appli. 2 CSIS 230 Networking Op. Systems IT 108 Network Comp. Security IT 109 Virtual Computing IT 110 Forestry Courses Course # Grade Earth Science Courses Course # Grade Physical Geology ESCI 119 Intro to Forestry For 101 Physical Geology w/ lab Physical Oceanography ESCI 120 ESCI 130 Forest Ecology Plant Identification For 102 For 103 Intro to GIS ESCI 180 Outdoor Recreation For 104 Engineering Courses Statics Course# ENGR 135 Intro to Engineering ENGRA 101 Math Courses Intermediate Algebra Plane Trigonometry Pre-Calculus Calculus I Calculus II Calculus III Linear Algebra Intro to Statistics Course # Math 150 Math 151 Math 175 Math 190 Math 191 Math 210 Math 211 Math 165 Grade Wildland Fire Management For 105 Grade Wildlife Management For 106 Grade Physics Courses Intro College Phys Phys A: Mechanics Phys B: Thermo, E&M Phys C: Waves, Opt. Mo. Course # Phys 110 Phys 201 Phys 202 Phys 203 Grade Math Courses College Algebra Math Analysis Course # Math 170 Math 162 Grade Citrus ID #_____________________ Initials_______ RESEARCH INTERESTS I have previous research experience through Citrus College or another school/program: � Yes � No If yes, please indicate date and location:_________________________________________________________ Please indicate the areas of research you are most interested in. Rank the categories below in order of preference with 1= most interested, etc. _____Biology _____Biochemistry _____Botany/Plant biology _____Chemistry _____Computer Science _____Engineering _____Earth/Planetary Sciences _____Fossils (Curating) _____Math _____Molecular & Cellular Biology _____Physics Please indicate any research area(s) you would NOT want to be considered for? _________________________ Background Information Birthdate: _____/_____/_____ Gender: � Female � Male � Transgender Check One: �US Citizen �US Permanent Resident �Deferred Action �AB540 �International Ethnicity (check all that apply): � African-American � Native American � Asian � White � Hispanic/Latino � Pacific-Islander � Other: ____________________________ Have either of your parents/guardians completed a Bachelor’s degree or higher? � Yes � No Are you currently working? � Yes � No Hours per week? _________________________________ If yes, where are you working? ________________________________________________________________ Do you have any disabilities or special needs? � Yes � No If yes, please explain:________________________________________________________________________ Are you currently a member or a veteran of the armed forces? � Yes No Branch: _____________________ Please indicate the types of financial aid you are currently receiving: � Board of Governor’s Fee Waiver (BOG) � Cal Grant � Federal Work Study � Cal Works � Pell Grant � GI Bill � Not eligible for aid Please attach a copy of your award letter. To find your award letter: log on to Wingspan, click on the Financial Aid tab, and then click on “Award.” Next, click on “Award for Aid Year.” Select 2013-2014 award year. Next click on the “Award Overview” tab. Print the report and attach it to the application. Have you ever been convicted of a crime other than minor traffic violations, including Nolo Contendere Plea (a plea of no contest)? This does not automatically disqualify you for Summer Research � Yes � No Citrus ID #_____________________ Initials_______ Letters of Recommendation A complete application includes two letters of recommendation. List the names of the Citrus instructors or administrators you have asked to write letters of recommendation. Make sure to ask early so recommenders have time to submit their letters by the deadline. The recommendation form can be found online at: http://www.citruscollege.edu/stem/summerresearch/Pages/ 1. __________________________________________ 2. ______________________________________________ Short Answers (please attach your typed responses) 1. What interests you about participating in a summer research experience? If you participated last summer or during the academic year, what would you like to accomplish in a second experience? 2. Briefly discuss your involvement in any college programs, clubs and/or activities. If you have not yet had an opportunity to participate, what has kept you from becoming involved? 3. Briefly discuss how you have spent time outside of attending classes and completing homework during the past two years. Have you been involved with extracurricular activities? Family responsibilities? Work? Community Service? Personal Statement (please attach your typed response) In 500 or fewer words, describe what interests you in STEM fields (science, technology, engineering, math). Tell us about yourself and include your short and long term goals. How has your background led you to these goals and interests? How do you plan to achieve these goals? Indicate any special skills or experiences that will help you achieve these goals.