REU Pre-Application Form

Please fill out this form as a notice of your intent to apply via mail. It is not a substitute for mailing in an application packet, but will help us make our decisions. It is especially suggested that applicants nearing the deadline submitt this form.

Your name (required):

Your street or P.O. Box address (required):

City (required):   State (required):   Zip (required):

Phone (required):   e-mail (optional):

Spring Break (optional):

Your University (required):

Is this the first time you have applied to REU? Yes   No

Please check your educational status: Junior   Senior

Check all groups to which you belong (OPTIONAL): Women   Hispanics  
American Indians   Blacks   Native Alaskans   Native Pacific Islanders

Select your Primary Choice of area of study (required):

Select your Second Choice of area of study (required):

Please give us 10 lines or less explaining why you are a good fit for our program
(Statement of Interest brief):

Please List your Top Four mathematics courses relevant to your interests:

Please Indicate your Computer-Related Proficiency by naming languages and software packages
your are familiar with (If relevant to your area of study):

Name/Address(and if possible Phone/Email) of Faculty who will submitt
"Faculty Sponsor Form" (1) (Required):

Name/Address(and if possible Phone/Email) of Faculty who will submitt
"Faculty Sponsor Form" (2) (Required):

 

Thanks for filling out this form. Comments or questions can be directed to the Terence Blows at (520) 523-6863 or email us at: terence.blows@nau.edu