ࡱ> HJG@ *jbjbqq "N$l4444444 dfsss,n ~4sssss44s 44H^^4444s5 h44t$Jr}   EAST SURF Application Checklist Your complete application must contain the following information: _____1. Application Cover Sheet. _____2. Personal Statement. Provide a statement describing your academic interests and career goals. Indicate how an EAST Summer Undergraduate Research Fellowship will assist you in attaining these goals (one page maximum). _____3. Project Description. Provide a two-page description of your project. Include the following information: Title. Abstract (200 words maximum). Introduction. Provide a concise statement of what you want to do and what you want to learn: the project goal or research question to be answered. Background. Explain the current understanding of knowledge in the field and previous work related to your project. Objectives. Include a list of objectives for your project and the specific steps you need to take, or what you need to accomplish, in order to reach your project goal or answer the research question. Significance. What is the significance of your project? What is the expected impact of your work within your field, and/or to society in general? Methods. Provide a description of the research methods/approach to be used. _____4. Work Plan. Provide an explanation of the projects logistics, including: Where the research will be conducted; Time line for project activities for each week of the eight-week summer program; and Details as to how you and your research supervisor plan to meet during the summer to discuss the progress of your research. _____5. Optional Budget Form and signatures of you and your research supervisor. This form is necessary only if your project requires additional expenses. You may apply for up to $400 to help cover costs directly related to your research, such as books, supplies, travel, or photocopying. _____6. Agreement to Fulfill Program Requirements and signatures of you and your research supervisor. _____7. Letter of Recommendation from your research supervisor. _____8. Copy of your current college transcript (Please include courses through fall 2003). 1. EAST SURF Application Cover Sheet Last Name: _____________________ First Name: _____________________ M.I.:_____ Project Title: _____________________________________________________________ Institution: _______________________________________________________________ College Address: _______________________ Permanent Address: _________________ _______________________ __________________ _______________________ __________________ College Phone: ________________________ Home Phone: _______________________ E-mail Address: ___________________________________________________________ Expected Graduation Date: ______ Major(s): ___________________________________ (Students graduating in May 2004 are NOT eligible for EAST Summer Fellowships.) Academic standing as of January 1, 2004: ___Freshman ___Sophomore ___Junior ___Senior Overall GPA: _____________ GPA in Major: _______________ Optional: Race/Ethnicity: ______________________________________________________ Gender: _______________ Disability Status: __________________________ Research Supervisor: ______________________________________________________ Institution: _______________________________________________________________ Department: _____________________________________________________________ Address: ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Phone: ________________________________________________________________ E-mail Address: ___________________________________________________________ 2. EAST SURF Personal Statement Please provide a statement describing your academic interests and career goals. Indicate how an EAST Summer Undergraduate Research Fellowship will assist you in attaining these goals (one page maximum). 3. EAST SURF Project Description Please provide a two-page description of your project. Include the following information: Title. Abstract (200 words maximum). Introduction. Provide a concise statement of what you want to do and what you want to learn: the project goal or research question to be answered. Background. Explain the current understanding of knowledge in the field and previous work related to your project. Objectives. Include a list of objectives for your project and the specific steps you need to take, or what you need to accomplish, in order to reach your project goal or answer the research question. Significance. What is the significance of your project? What is the expected impact of your work within your field, and/or to society in general? Methods. Provide a description of the research methods/approach to be used. 4. EAST SURF Work Plan Please provide an explanation of the projects logistics, including: Where the research will be conducted; Time line for project activities for each week of the eight-week summer program; and Details as to how you and your research supervisor plan to meet during the summer to discuss the progress of your research. 5. EAST SURF Optional Budget Form Please complete this form only if you are requesting EAST funds to help cover some of the costs of conducting your research. You may apply for a maximum of $400 for materials and supplies, books, research-related travel, or photocopying costs. Please be as specific as possible. Budget Categories (include a brief explanation of expense) Amount Requested Books: $________________ Supplies: $________________ Research-Related Travel: $________________ Photocopying: $________________ Other (Please specify): $________________ TOTAL AMOUNT REQUESTED: $________________ Students Name (printed): ___________________________________________________ Students Signature: _________________________________________ Date: _________ As the research supervisor, I certify that this budget is reasonable for the proposed project. Research Supervisors Name (printed): ________________________________________ Research Supervisors Signature: ______________________________ Date: _________ 6. EAST SURF Agreement to Fulfill Program Requirements (for the student and for the research supervisor) For the Student: EAST SURF awards are dependent upon your agreement to fulfill each of the following program requirements. Indicate your agreement by placing your initials on each line: __________ I will participate in the EAST Summer Undergraduate Research Program for eight weeks during summer 2004. I plan to conduct research full time (about 40 hours per week) as directed by my research supervisor. __________ I am registered as a full- or part-time student in good academic standing, and I will be a full- or part-time student through at least the fall 2004 semester. __________ I agree to provide EAST staff with a written report of my summer research work and research results by October 1, 2004. __________ I agree to acknowledge EAST in all publications and presentations resulting from this fellowship and to provide EAST staff with copies of all publications or conference abstracts. __________ I agree to share my research at my colleges/universitys student research conference, if applicable. __________ I agree to share my research/receive recognition at EASTs annual Day of Celebration (meals and mileage reimbursement provided). ___________ I agree to participate in evaluation activities around EAST. I agree to fulfill all of the above program requirements, and I certify that all information provided in this application is accurate and complete. Students Name (printed): ___________________________________________________ Students Signature: _________________________________________ Date: _________ For the Research Supervisor: Indicate your agreement by placing your initials on each line. __________ I agree to provide direction and supervision to ________________________ as an EAST Summer Undergraduate Research Fellow during summer 2004. ___________ I agree to participate in evaluation activities around EAST. Research Supervisors Name (printed): ________________________________________ Research Supervisors Signature: ______________________________ Date: _________ 7. EAST SURF Letter of Recommendation from your research supervisor Please include a letter of recommendation from your research supervisor or have your research supervisor mail it directly to: Nancy Lightbody EAST University of Southern Maine Lewiston Hall, Building 4, 60 Pineland Drive New Gloucester, ME 04260-5113 Voice (toll-free): (866) 688-4573, ext. 148 TTY: (207) 688-4591 FAX: (207) 688-4036 8. EAST SURF Copy of Your Current College Transcript Please include a Copy of Your Current College Transcript. Please include courses taken through fall 2003. You may also have your college mail it directly to: Nancy Lightbody EAST University of Southern Maine Lewiston Hall, Building 4, 60 Pineland Drive New Gloucester, ME 04260-5113 Voice (toll-free): (866) 688-4573, ext. 148 TTY: (207) 688-4591 FAX: (207) 688-4036   !#$FHIXlmYz | \!k!!p"o#p#|###M$N$O$P$$ %L%%%/&&'g(h(((()* 5OJQJ>*5>*OJQJCJ5OJQJ5CJ@ !cdgh  & FaP^a`   & FP^ a4P & FP^  a|^`|  84P7$8$H$   4P $7$8$H$a$  !cdgh ` % {    FGHI56@A./^_`aFG !                          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