Cornell Engineering : LSAMP Summer Application

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LSAMP Summer Application

Applicant Information

Last Name:

First Name:

Current Address:

City:

State:

Zip Code:

Current Phone :

E-mail address:

Date of Birth:

mm/dd/yy

Institution:

Major:

Cumulative GPA:

Major GPA:

Scale:

4.0

5.0

Expected Graduation Month:

Expected Graduation Year:

ie. 2009, 2010, etc.

Demographic Information

Gender:

Male

Female

Ethnicity:

African-American

American Indian

Asian

Hawaiian/Pacific Islander

Hispanic/Latino

White

Alaska Native

Please check all that apply.

Nationality:

I_551_Card_No:

Permanent Residents Only

Other Information

Is your school apart of ULSAMP?:

If yes, please select one::

Is your school apart of another LSAMP?:

If yes, please enter school name:

CORNELL UNIVERSITY STUDENTS ONLY

Do you need summer campus housing?:

Do you need a parking pass?:

NON-CORNELL UNIVERSITY STUDENTS

Select One:

Bus Pass

Parking Pass

Application Essay

Please address the following:
- Your research interests
- Your plans upon your undergraduate graduation
- Explain how this research opportunity relates to your career goals and academic plans

Essay:

Please paste your responses into the box provided, and limit your responses to two pages.

Optional

Identify specific Cornell University faculty members with whom you wish to conduct research with during the program and briefly explain why you desire to perform research with those particular faculty members.

We will explore the options to facilitate a pairing a faculty identified in the optional section; however, participants are not guaranteed to be paired with faculty identified in the section.

Name of Faculty Member:

Name of Department:

Have you contacted the Faculty Member?:

Yes

Explanation:

Please print out the Recommendation Form and provide it to your recommenders. Remember to submit two letters of recommendation with your application. See form for more details.

Did you complete and submit the following?

Application Form (online)
Academic Transcripts (mail/fax)
Two (2) letters of recommendation (mail/e-mail/fax)
Application Essay (online)
Optional: You may include a resume if you wish to provide relevant work experience information (mail/e-mail/fax).
Optional: Provide any additional information that the review committee should consider (mail/e-mail/fax).

Diversity Programs, Cornell Engineering

Attn: LSAMP-R

146 Olin Hall

Ithaca NY 14853

E-mail

dpeng@cornell.edu

Fax

607.255.2834

Phone

607.254.5202

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