Active Minds Changing Lives
Full name:
Address:
Phone number:
e-mail address:
Citizenship:
Race or Ethnicity
Sex:
Class standing:
University:
Major:
This information is requested to assure that applicants qualify for the program as defined by the National Science Foundation.
Highest math completed:
Chemistry courses completed:
Biology courses completed:
Current courses:
Please provide a 1-2 page statement describing your general background, interests, and educational goals. You will probably want to write the statement in a word processing program and paste it below.
To complete your application, you must send 1) a current transcript (unofficial copy acceptable) and 2) a letter of recommendation from a faculty member familiar with your academic record. These materials can be sent via e-mail (Brian.Bingham@wwu.edu), FAX (360-293-1083) or regular mail to:
