NIST SURF Program Student Application - Boulder

^{SURF Boulder}

Summer Undergraduate Research Fellowship Program

National Institute of Standards and Technology, Boulder, Colorado Student Application Form

(To be filled out by student applicant and included with completed Institutional Application package. DO NOT SEND SEPARATELY.)

Name E-mail address

Current address

Institution Phone number

Permanent address

Major/Minor

Current Class Standing (check only one) : Freshman Sophomore Junior Senior

Expected Graduation Date

Current Overall GPA

Current Major GPA

(To be eligible for the SURF program, your expected graduation date must not precede the summer program. This restriction does not apply to returning SURF NIST Boulder students.)

Have you previously participated in one of NIST’s SURF programs? Yes No

If Yes: Year

Location: Boulder Gaithersburg Mentor

If you were to return to Boulder, would you prefer to work with the same mentor? Yes No N/A

List (by reference number) the 6 research opportunities in which you are most interested, in order of preference.

^{Try to include opportunities from at least two different divisions. (Go to http://www.nist.gov/surfboulder for}

the current list of Research Opportunities.)

1.

2.

3.

4.

5.

6.

Will you be able to be in Boulder from xx/xx/xxxx to xx/xx/xxxx (11 weeks)?

Yes No. I can be in Boulder as early as through as late as_ . (Total availability period should span at least 11 weeks.)

If accepted, what are your plans for housing?

^{Will room with other SURF students (recommended)}

Will live with family in or near Boulder

Will find my own

How did you hear about the SURF NIST Boulder program? Are you also applying for the SURF program at NIST in Gaithersburg, Maryland? Yes No

Submit your completed Student Application Package to your school contact for inclusion with the Institutional Application Package. DO NOT SEND YOUR STUDENT APPLICATION SEPARATELY.

APPLICATION DEADLINE: February 15

Completed Institutional and Student Application Packages should be sent to: Cynthia Kotary, NIST - 104.00, Bldg.1, Room 4006B, 325 Broadway, Boulder, CO 80305

Phone: 303-497-3319, E-mail: cynthia.kotary@nist.gov, Website: http://www.nist.gov/surfboulder

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