Biological Sciences Department San Jose State University

I. Demographic information: Name: Address: Street City State Zip Phone number*: E-mail address: ______________________________ * (We may call you for a phone interview) Date of Birth ________________________________ Eligibility (check one): ___ US Citizen ___ Permanent Resident Gender ____ Male ____ Female Ethnicity (voluntary information): ___ African American ___ American Indian ___ Asian ___ Caucasian ___ Hispanic ___ Pacific Islander II. Education Community College/University: Academic Classification: ____ Freshmen ____ Sophomore ____ Junior ____ Senior Current Major: _______________________ GPA in science/math courses: ____________ Overall GPA: ___________________ Expected degree__________________________________ Expected date of graduation: III. Career Goals Graduate school (MS/PhD.)_______ Medical School_______________

Career in biotech company____________________ Undecided___________________ IV. Describe how participation in our REU Program will benefit your educational or career goals (500 words). For example, you might answer the following questions. Do you have any previous experience in laboratory science? How did you become interested in molecular biology?

V. List in order of preference your choice of RUMBA faculty mentor. Discuss in two sentences the reasons for choosing your preferred potential mentor. Dr. Ouverney______ Dr. Lee______ SSCL*_______ Dr. VanHoven_______ Dr. Soto______ Dr. White_______ VI. References Include two sealed reference letters from two faculty members that know your abilities and interests. Format: The application form must be submitted by regular mail. This application form is writable. Mail a typed application form, reference letters and personal copies of transcripts to:

Dr. Julio Soto Department of Biological Sciences San Jose State University One Washington Square Duncan Hall 254 San Jose, CA 92192-0100

.