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1 Terrestrial Ecology Research Lab, Department of Biological Sciences,, San Marcos A completed application contains: Names and contact information of references Statement of interest List of college/university science courses taken and grade received Completed Environmental Science Survey Form See page 3 of this application for program information Contact information: Last Name First Middle ID Number Street address City State Zip Telephone Major(s) Reference contact information: Please provide names of two people who could serve as references. Reference 1 Last Name First Telephone Reference 2 Last Name First Telephone Transcript information: Please list all science and mathematics courses taken at the college and university level including the course name and number, name of college or university institution, year taken, and grade received. Additional courses can be appended to this application as needed. Course Name & Number Institution Name Year Taken Grade Page 1 of 5 Revised 1/2011

2 Terrestrial Ecology Research Lab, Department of Biological Sciences,, San Marcos Statement of interests: Please attach a brief statement (essay) that describes why you are interested in this program. Possible topics may include why you would be an exceptional candidate, your educational and career goals, and/or your research interests. Page 2 of 5 Revised 1/2011

3 Terrestrial Ecology Research Lab, Department of Biological Sciences,, San Marcos Program description: USDA-HSI: Development of a new generation of environmental scientists through an undergraduate program of inquiry-based instruction, independent research, and professional development. The overall goal of this project is to attract, train, and support underrepresented undergraduate students in field of environmental science. Participants will be provided (1) intensive summer instruction, (2) independent research opportunities, (3) internships with USDA or other agencies, (4) opportunities to disseminate research results at a U. S. scientific meeting, and (5) instructional support and mentoring as students work toward achieving their Bachelor of Science (BS) degree. Eligibility: Freshman-junior minority students majoring in biology or related science disciplines (6 participants/year). Timeline Year 1 Year 2 Year 3 and beyond Intensive summer training (July August). Participants receive a stipend to defray course fees and to allow students to focus on course activities. Independent re se arch (fall spring semesters) Paid 8 week internship at a USDA re se arch lab or other appropriate facility. Support for travel and participation in a U.S. Professional Conference to disseminate research results. Participation in the CSUSM MARC and/or RISE programs. Continued mentoring and support for degree completion. For more information, contact Dr. George Vourlitis Department of Biological Sciences Science Hall 1- Room 320 Phone: Fax: georgev@csusm.edu Completed applications must be returned to: Dr. George Vourlitis Department of Biological Sciences Science Hall 1- Room 320 Phone: Fax: georgev@csusm.edu OR Ms. Rita Cooper Office of Biomedical Research and Training Academic Hall- 410 Phone: Fax: rcooper@csusm.edu Page 3 of 5 Revised 1/2011

4 Environmental Science Course: Semester: Fall Spring 201 Thisshortsurveyisdesignedtoassessstudentinterestandfamiliaritywiththefieldofenvironmental science.completingthesurveyisvoluntary,andyourresponseswillbeusedtoinformtheenvironmental sciencescurriculum.completingthesurveywilltakeabout5minutes,andyourresponseswillbecompletely anonymous.questionsaboutthissurveyshouldbedirectedtoprofessorgeorgevourlitis 1. CurrentCumulativeGPA: 2. ClassStanding:(circleone) Freshman Sophomore Junior Senior 3. DidyoutransfertoCSUSMfromanothercollegeoruniversity?YN IfYES,whatwasthenameoftheschool? ONASCALEFROM0(NOTATALL)TO10(AGREATDEAL) (0=notatall)(10=agreatdeal) 4...whichbestdescribesyourinterestinpursuinga bachelor sdegreeatcsusminenvironmentalscience?(circle yourresponse) 5..whichbestdescribesyourinterestinpursuingacareerin environmentalscience? whichbestdescribesyourinterestinconductingresearch inthefieldofenvironmentalscience? whichbestdescribesyourinterestinattendinga graduateprograminenvironmentalscience? ONASCALEFROM0(NOTATALL)TO10(AGREATDEAL) (0=notatall)(10=agreatdeal) 8..howknowledgeableareyouaboutthefieldof environmentalscience? howknowledgeableareyouaboutthecareer opportunitiesinenvironmentalscience? Ifyouwantedto,howconfidentareyouthatyoucould completeabachelor sdegreeinenvironmentalscience? Ifyouwantedto,howconfidentareyouthatyoucould obtainajobworkinginthefieldofenvironmentalscience?

5 12.Haveyoueverparticipatedinasciencetrainingprogram?(checkallthatapply) MARC MBRS RISE Bridges LuisStokesAMP Other(specify) 13.Thissemester,areyouinvolvedinanyresearchactivities? No Yes,aspartofalaboratorycourse Yes,asapaidposition Yes,aspartofanindependentstudyactivitywithafacultymember Yes,other(pleasedescribe) 14.Isthereafacultymemberthatyouwouldconsideramentor?(Amentorissomeonewhoprovides guidance,assistance,andencouragementonprofessionalandacademicissues). No Yes(describe): 15. Duringthecurrentacademicterm,approximatelyhowmanyhoursperweekdoyouplantoworkforpay? (hours) 16. Whatisyoursex? Male Female 17. AreyouofHispanic,Latino,orSpanishorigin? No Yes 18.Withwhichofthefollowingracialgroupsdoyouidentify(checkallthatapply) White BlackorAfricanAmerican AmericanIndianorAlaskaNative Asian(includingAsianIndian,Chinese,Japanese,Korean,orotherAsian) Other(Specify): (THANKYOU)