UW-Casper and Casper College Undergraduate Research Application

If you have technical difficulties please contact Dagmara Motriuk-Smith at motriuk@uwyo.edu or 268-2542

Last Name *

First Name *

Student ID

Birth Date *

School e-mail *

Personal e-mail address used frequently *

Phone Number *

Can we ocassionally send text reminders to the above number? *

Yes No

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Hometown *

Home state *

Are you a resident of Wyoming? *

Which College/University are you attending? *

What is the highest degree you earned so far? *

Current GPA *

Expected graduation date (Month/Year) *

What is your major? *

Second major?

Minor?

Are you a first generation college student? (Neither parent has a bachelor's degree.) *

What is the HIGHEST degree you eventually hope to earn? *

Once you finish your current degree program, what do you see as the IMMEDIATE next step in your career path? *

What are your long-term career goals? *

To conduct research in an industry setting To conduct reaserch at a university To practice medicine To teach (grades K-12) To teach (college/university level) To work in the allied health professions (nursing, pharmacy, etc.) Other

If you selected "Other" please explain

Select which semester(s) you are applying for? *

Type of research you will be working on? *

Faculty Mentor's Last Name *

Faculty Mentor's e-mail address *

Name of 1st faculty reference: *

Name of 2nd faculty reference: *

Have you received an INBRE fellowship before? *

Yes No

If so, what semester(s) and year(s)?

All documents must be submitted in a readable PDF.

(To convert a Microsoft Word file to a PDF, select File. You will select Save As. Below the File Name, there is a drop down menu. There will be several programs listed, select PDF)

If you do not have Adobe PDF, download here: https://get.adobe.com/reader/

Upload File-PDF Letter of Intent or Research Proposal *

Upload File -PDF (unofficial) Transcipts *

Incomplete or late applications will not be reviewed.

If I am awarded the WY INBRE Research Internship I agree to the following terms:

Work hours agreed upon with your mentor (typically 10 hrs per week during spring and fall and at least 20 hrs per week during summer)
Submit a written report summarizing conducted research
Present a poster and an oral presentation during the spring Wyoming Undergraduate Research and Inquiry Across Disciplines event and the Fall WY INBRE Statewide Retreat
Attend the INBRE videoconference seminars (usually Fridays around noon), two seminars per semester
Complete the required training modules

Please sign your full name below:

Name *

First Name Last Name

UW-Casper and Casper College INBRE Undergraduate Research Application