Support Provided By:

National Science Foundation

 

University of Oregon

 

Materials Science Institute

Cooperating Community Colleges:

PCC logo

 

COCC logo

 

Chemeketa CC
Lane Community College

 

Mt. Hood CC

 

 

UCORE Flyer

Undergraduate Catalytic Outreach and Research Experience

On-line Application Form

Due on or before March 17, 2008

Personal Information

  
Title:
 
First name:
 
Middle Initial:
 
Last Name:
 
E-Mail Address:
 
Re-enter to confirm your E-mail:
Current Address at School:
 
Street or dormitory:
 
City:
 
State:
 
ZIP:
 
Current Phone (include area code):
Home (Permanent) Address:
 
Home Address:
 
City:
 
State:
 
ZIP:
 
Home Phone (include area code):

College/University Information
College or University currently attending:
 
Other Colleges / Universities attended:
  Your summer availability in 2007 (format MUST be MM/DD/YYYY)
 
From:
 
Until:

 

You may cut and paste from a word processing document into the fields below if the information is plain text only (no special characters or graphics). If you encounter an error submitting this application, these fields are the most likely source of problem.

Please give us a statement of reasons why you would like to participate in this program:


  Please list any awards, honors or other notable accomplishments:

  Briefly outline your current goals and proposed career path:
   
  What do you hope to be doing 5 years from now?:
   
  Briefly describe the college/educational background of your immediate family:

Have you had any experience in a science research program?
 
If 'yes,' please give type and description of the research:
 
     
 

Academic Information

  Please give course name, credit hours granted and grade received for each course listed below. You should also note science/math course you anticipate completing by the end of Spring term 2007.
Once you have successfully submitted this form, you will receive information on where to mail a copy of your transcripts. An unofficial copy is acceptable.
 
Science lecture courses:
 
Science laboratory courses:
 
Math courses:
 
 
 
Overall GPA:
 

 

  
  To help the Program comply with a commitment to the National Science Foundation, you are urged to identify your demographic data. You may decline to do so without prejudicing the action taken on your application.
 
Gender:
 
Race:
 
Ethnicity:
 
Disability:
 
Citizenship:
     
 

References

  
  Two references are required. It is your responsibility to contact your references and request that they endorse your application.
 




Please check either yes or no

Waiver: By checking the Yes box to the left, I expressly waive any rights I might have to access this recommendation under the Family Educational Rights and Privacy Act of 1974, or any other law, regulation or policy.
I understand that I am not required to execute this waiver and my application will be reviewed whether or not I check here.
 
Reference #1:
  
 
Title:
 
First Name:
 
Last Name:
 
Position / Affiliation:
 
Street Address:
 
City:
 
State:
 
ZIP:
 
Telephone (include area code):
 
FAX (include area code):
 
E-mail:
 
Reference #2:
 
 
Title:
 
First Name:
 
Last Name:
 
Position / Affiliation:
 
Street Address:
 
City:
 
State:
 

ZIP:
 
Telephone (include area code):
 
FAX (include area code):
 
E-mail:

Important! Please review your application now.

Do NOT press the 'Submit' button until the form has been COMPLETELY filled out.