Application

Today's date: *

First Name: *

Last Name: *

Address (Line 1): *

Address (Line 2):

City: *

State: *

ZIP: *

Phone: *

E-mail Address: *

University/College: *

State of University/College: *

Other:

Year of Ph.D.: *

Number of years at current position: *

Current research area: *

Number of undergraduates you have worked with on research: *

1-3

4-9

10+

Highest degree offered by your institution in Math./Stat./CS : *

Associate

BA/BS

MA/MS

Ph.D.

Is your institution a HBC (Historical Black College) or HSI (Hispanic Serving Institution)?: *

HBC

HSI

Neither

We strongly encourage applicants to reapply if they are not funded. Have you applied for a CURM mini-grant during the past two years?: *

Yes

Demographics of projected undergraduates who will work on this research:
(Student participants must be United States citizens or permanent residents.)

Total number of projected students: *

Number of projected students:

Number of:

Males: *

Females: *

Grade level:

Freshman: *

Sophomore: *

Junior: *

Senior: *

Ethnicity:

African American: *

Native American: *

Pacific Islander: *

Hispanic: *

White: *

Briefly state your plans for using the $6,000 stipend from CURM: *

Personal Statement: *

Please provide a one page personal statement describing your experience in undergraduate research, the types of students you plan to work with, and why you and your institution should be awarded a CURM mini-grant instead of another applicant.

Description of Research Project: *

Please provide a one page description of the proposed research project including 1-2 proposed research problems for the students to investigate.

Letter of Support: *

Please provide a letter of support from your Chair or Dean stating how the $6,000 stipend will be used to modify your teaching load so that you will have more time for undergraduate research.

Vita (up to two pages): *