* Personal Email * Alternate Email *
Phone * I am 18 years of age or older * Yes No I am a U.S. Citizen, U.S. National, Permanent Resident of the U.S. Yes No College/University Attending * City * State * Major * Current Year In School * Freshman Sophomore Junior Senior Year/Grade entering into this Fall * Have you received a Bachelor's degree? Yes No Is your school a 2 year college? * Overall GPA to date * Are you a first generation college student? * Yes No Are you available for the full 10 weeks of the internship (first full week in June through the second week in August)? * How did you learn about the Mystic Aquarium REU internship? * Please rank order your top 3 mentors that you would like to work with by indicating #1, #2, and #3 next to the mentor’s name. A number 1 indicates your first choice. See section on Mentors and Research Projects for a description of the mentor’s research interest and projects. Heidi Dierssen, PhD - Primary Producers Ann Bucklin, PhD – Primary Consumers Hans Dam, PhD – Primary Consumers George McManus, PhD – Primary Consumers Evan Ward, PhD – Primary Consumers Hannes Bauman, PhD – Secondary Consumers Paul Anderson, PhD – Secondary Consumers Tracy Romano, PhD – Apex Consumers Indicate why you chose each mentor and the professional goals you hope to achieve by working with each mentor (approximately 1-2 sentences for each mentor). * VOLUNTARY SUPPLEMENTAL DATA SHEET FOR EQUAL EMPLOYMENT OPPORTUNITY/ AFFIRMATIVE ACTION INFORMATION/VETERAN STATUS
Sea Research Foundation, Inc. is an Equal Employment Opportunity/Affirmative Action employer. We consider all applicants or employees for all positions without regard to age, gender, sexual orientation, race, color, religion, ethnicity, national origin, disability, marital status, veteran status, or any other legal recognized protected basis under federal, state or local laws, regulations or ordinances
We are subject to certain governmental recordkeeping and reporting requirements. In order to comply with these laws, we invite applicants/employees to voluntarily self-identify their race or ethnicity and veteran status. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws. When reported, data will not identify any specific individual.
Gender Male Female Race White (Not Hispanic or Latino) Black or African American (Not Hispanic or Latino) Hispanic or Latino Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) Asian (Not Hispanic or Latino) Native Alaskan (Not Hispanic or Latino) Native American (Not Hispanic or Latino) Veteran Status Disabled Veteran means (i) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs, or (ii) a person who was discharged or released from active duty because of a service-connected disability. Other protected veteran means a veteran who served on active duty in the U.S. military, ground, naval, or air service during a war or in a campaign or expedition for which a campaign badge has been authorized. Armed Forces Service Medal Veteran means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985 (61 Fed. Reg. 1209) Recently Separated Veteran means a veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval or air service. Voluntary Self-Indentification of Disability
Because we do business with the government, we must reach out to hire and provide equal opportunity to qualified people with disabilities. To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.
If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self-identify as having a disability on this form without fear of any punishment because you did not identify as having a diability earlier.
How do I know if I have a disability?
You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.
Disabilities include, but are not limited to:
Blindness, Deafness, Cancer, Disabetes, Epilepsy, Autism, Cerebral Palsy, HIV/AIDS, Schizophrenia, Muscular dystrophy, Bipolar disorder, Major depression, Multiple Sclerosis, Missing limbs or partially missing limbs, Post-traumatic stress disorder, Obsessive compulsive disorder, Impairments requiring the use of a wheelchair, Intellectual disability (previously called mental retardation).
Please choose one of the boxes below Yes, I have a disability (or previously had a disability) No, I don't have a disability I don't wish to answer Your Name Date
Letters of Recommendation
List the two individuals submitting the letter of recommendation. *One must be from a current academic instructor. Your application will not be reviewed until both letters are received. The letter should include an assessment of your academic abilities and accomplishments, work ethic, motivation, ability to work a team oriented environment, potential as a researcher, and your ability to participate in and benefit from a research internship in marine science.
References should be emailed directly to
[email protected] Name *
Title * Affiliation * Email *
Relation To You * Name *
Title * Affiliation * Email *
Upload a PDF file of your unofficial transcript. Include all semesters completed. Note: An official transcript will be required upon acceptance to the program. * Upload a 2-page essay describing your personal and professional goals and why you are interested in the Mystic Aquarium REU *
I certify that the above information is accurate. *