NCSU AGEP Undergraduate Student Application

ARE
SRE


Personal Data

Name:
Address:
City:
State:
Zip:
Phone:
Email:
Date of Birth:
Place of Birth:

Citizenship Status:
US Citizen or National
Permanent Resident of the US

Gender:
Male
Female

Ethnicity:
African American
Alaskan Native
American Indian
Caucasian
Hispanic
Native Pacific Islander
Other


Academic Information

Year:
Freshman
Sophomore
Junior (rising Senior)
Senior (not graduating)

 

Major:
Minor:
Department of Graduate Study:
Name of Current Advisor:
Advisor's Email address:
Faculty member at NCSU with whom you want to work:


Education Information

Prior Education (from most recent to least recent)
Name of School:
Location:

Dates of Attendance
From:
To:
Date Degree Received (if applicable):
Degree:
Major:

Prior Education (from most recent to least recent)
Name of School:
Location:

Dates of Attendance
From:
To:
Date Degree Received (if applicable):
Degree:
Major:

Undergraduate GPA:
Out of Possible:

Undergraduate Major GPA:
Out of Possible:


Honors and Awards

Please list any memberships, honors, or awards:


Former Research Experience

Please briefly describe prior research experience:

Prior research experience is not required for admission to AGEP.


Statement of Purpose

Please write a statement of purpose clearly indicating the following:

  1. your reason for wanting to participate,
  2. your research interests, and
  3. how your participation will further the goals of AGEP, including what makes you a great candidate