2006 BECKMAN SCHOLARS PROGRAM APPLICATION University of Florida

Please type or print legibly in ink. Include with the completed dossier: (i) this form (ii) a University of Florida transcript showing Spring 2006 midterm grades (photocopy OK), and (iii) a resume (iv) a statement of purpose describing your long-term research interests and career goals (limit 2 pages - typed), (v) your past research experience and accomplishments (if any - limit 2 pages, typed), and (vi) your research plans targetted at one or more of the available mentor research groups (background, goals, and methods, typed, limit 3 pages).  In addition, letters of support should be submitted by two faculty members directly to the program.

Completed materials should be received by 4pm March 1, 2006 to F. Green, Tigert Hall, room 135.

1. Name_______________________________________ UF ID no. ___________________ Citizenship____

2. Campus Address _________________________________________________

____________________________________________ Telephone (_______) ____________________

Permanent Address _______________________________________________

____________________________________________ Telephone (_______) ____________________

Email ________________________________________________  Parents names ____________

3. Current Academic Status: Freshman ________ Sophomore __________ Junior __________ Expected Graduation Date: __________

4. Major or planned major _____________________ Minor/Option/Track (if any) _____________________

5.  SAT quantitative score  __________  SAT verbal score  ____________  UF cumulative gpa ________

6. Academic History (include Academic Honors and Awards, attach pages if necessary):
College (s) attended since high school graduation
Date entered

(month/year)
Date left

(month/year)
Academic Honors or Awards Received






7. Names of the two faculty members whom you have asked to write letters of recommendation.

 

8.  Proposed UF Beckman Mentor(s)

 

Optional: to be used for statistical purposes only

 

Please describe your ethnic/racial status:

___ American Indian or Alaskan Native    ___ Hispanic                    _____ Asian

___ White, not of Hispanic origin            ___ Pacific Islander            ____ African-American

If chosen as a Beckman Scholar, I agree to participate fully in the activities of the Program, including engaging in two summers of full-time research (2005 and 2006) and one academic year of part-time Honors research, and to attend the Beckman Meeting July 28-30, 2005.


Signature ____________________________________________________________ Date ______________