Summer Undergraduate Research Program

Summer 2010 Application (Deadline February 1, 2010) * indicates required fields
Name	First*		Middle
Last*
Address	Street*		City*
State*			Zip*
Phone	Home*		Work
Cell
E-mail:	E-mail*
Ethnic Origin:*
		Born U.S. Citizen		Naturalized U.S. Citizen
		Alien, Non Resident		Alien, Resident
Ethnicity:*
		Asian or Pacific Islander		Native American
		Black (Non-Hispanic Origin)		White (Non-Hispanic Origin)
		Hispanic		Multiracial
Undergraduate Institution:*
Major:*
Career Goal:*
Do you intend to pursue a master’s degree or higher?*
		Yes
		No
Current Grade Point Average (must be 3.0 or higher)* Please have an official transcript and proof from your Registrar that you are currently a junior at your institution submitted no later than February 1, 2010 directly to: Jack O. Jenkins, Ph.D. Special Associate to the President for Institutional Diversity Row Hall, 2nd Floor, East Wing University of West Georgia Carrollton, GA 30117 References: Please have two professors at your college/university who are familiar with your work, submit letters of recommendation to Dr. Jack Jenkins at the above address.
Please write a short essay (no more than 500 words) about why you believe you should be admitted to the summer research program at the University of West Georgia:*

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