Application: Student Summer Research Support

of Name Name(s)

Name *

First

Last

Email *

Mailing address *

ACS Member Number *

You must be an ACS member to apply. Join the ACS (https://www.acs.org/membership.html) or look up your member number (https://www.membernumberlookup.acs.org/eweb/ACSLookupTemplate.aspx?site=ACS_Lookup&WebCode=Lookup) .

Current University Affiliation *

Applicants must be enrolled at a higher education institution within the ACS Wisconsin Local Section (https://wisconsinacs.org/about/).

Projected graduation date (month and year) *

Major *

Applicants must be chemistry, biochemistry, or chemical engineering majors. If your major is chemistry-focused but is not one of those three options, please contact the ACS WI Local Section (contact form available on the website) to see if you can be considered.

Describe any previous research experience *

Name(s) of proposed summer research advisors *

Location of proposed summer research *

(company name and address, department/university and address, etc.)

Describe your proposed summer research project, including scientific justification *

Tentative start and end dates for summer research *

Requested amount (in dollars) and justification for support *

(Maximum amount is $2000)

Describe any additional support you are receiving for this summer research project *

Ex) pay/stipend, scholarships, fellowships, etc.

Your research advisor/professor must send a letter of support on your behalf.

They have already sent it
They are planning to send it

Please have your research advisor/professor send a letter of support to the WI ACS LS secretary, Levi Hogan, at: wisconsinacslocalsection@lists.wisc.edu

You will need to submit unofficial transcripts of undergraduate coursework.

I have already sent it to the email below
I am sending it right now to the email below
I am planning to send it to the email below before the deadline

Please send an unofficial transcript from all higher education institutions you have attended as an undergraduate to the WI ACS LS secretary, Levi Hogan, at: wisconsinacslocalsection@lists.wisc.edu