RESEARCH APPRENTICESHIP PROGRAM FOR HIGH SCHOOL STUDENTS (RAP) Please key or type all answers. Hand written applications will not be accepted. Once your part of the application is complete, print form, submit to your guidance counselor to complete, and sign in ink. Return the completed application along with a $25 non-refundable check or money order (NO CASH) and all required attachments by Friday, February 29, 2016 to Research Apprenticeship Program, School of Agriculture and Environmental Sciences, C. H. Moore Agricultural Research Station, North Carolina A&T State University, 1601 E. Market St., Greensboro, NC 27411-1011. Checks should be payable to: N.C. A&T University Foundation. NOTE: Applicant must be a U.S. citizen, have a minimum GPA of 2.8, and must be entering his or her junior or senior year for the 2016-2017 academic year. The application is not complete until the check has cleared. For more information, contact Kishaa James at (336) 285-4798, kdosunmu@ncat.edu. The research apprenticeship program will be held June 19 July 15, 2016. PERSONAL INFORMATION Date of application / / _ Name Street address City State Zip Email: Home telephone ( ) - Cell () - Date of birth / / Place of birth (City/State)_ U.S. citizen: Yes No Ethnic Group/Race - (Used for reporting purposes only. Check one.) American Indian or Alaskan Native Black (Non-Hispanic Origin) Asian or Pacific Islander Hispanic Caucasian Other Sex: Male Female IN CASE OF EMERGENCY CONTACT: (Relationship to applicant: father, mother, guardian, etc). Address:_ Home telephone ( ) -Work telephone ( ) -Cell: ( ) -
2 ACADEMIC ACTIVITIES Honors and Awards (check all that apply): Class officer Governor's School Who's Who National Honor Society Girls' or Boys' State Others (please list) Athletics (list activities) Extra-curricula/Special talents (list): POST HIGH SCHOOL PLANS Have you applied for admission to North Carolina A&T? Yes No If yes, intended major: First choice Second choice If yes, term you intend to matriculate: Fall semester, 2016 Spring semester, 2017 Fall semester, 2017 Have you been accepted for admission to North Carolina A&T? Yes No Pending If yes, specify major: _ If you have not applied for admission to North Carolina A&T, please list colleges/universities to which you have applied, or intend to apply including North Carolina A&T., and 1 st Choice 2 nd Choice 3 rd Choice How did you learn about the Research Apprenticeship Program? PLEASE NOTE: The complete application package must include the following: The application form completed by the student and high school counselor An official high school transcript, indicating the student s GPA and scores for the SAT or ACT. If no scores are available for the SAT or ACT, please indicate the test dates A statement of career interest (200-500 words, double spaced) describing why you are interested in the department major you selected on this form, and how you expect the pre-college experience will benefit you in making your future career choice Two letters of recommendation from counselors, principals, teachers, or community leaders Non-refundable application fee ($25). Students can participate in RAP only once.
3 Summer Research INTERESTS If selected for the program, indicate below the area in which you would like to conduct research in the School of Agriculture and Environmental Sciences (SAES). If more than one research area appeals to you, please rank them in order of preference: 1 = the highest, 2 = next highest, and so on. (For example: Natural Resources & Environmental Design = 1, Animal Sciences = 2, and so on). Agricultural and Environmental Systems (Agribusiness & Food Industry Management) Agricultural Education Animal Science Animal Industry Laboratory Animal Science Fashion Merchandising and Design Child Development and Family Relations Food and Nutritional Sciences - Food Science Biological Engineering Environmental Studies Sustainable Land Management Urban and Community Horticulture
4 CAREER INTERESTS Indicate the major (s) in The School of Agriculture and Environmental Sciences (SAES) which interests you the most. For more information about each major please check the website at and click on Academics. Department of Agribusiness, Applied Economics and Agriscience Education Agricultural and Environmental Systems (Agribusiness and Food Industry Management) Agricultural Education (Agricultural Professional Service) or (Secondary Education) Department of Animal Sciences Animal Science Animal Science (Animal Industry) Laboratory Animal Science Department of Family and Consumer Sciences Child Development and Family Studies (Child Development and Family Relations) Child Development and Family Studies (Early Education & Family Studies: Birth- Kindergarten Licensure) Family and Consumer Sciences (Fashion Merchandising & Design) Family and Consumer Sciences (Consumer Science) Food and Nutritional Sciences (Pre-medicine Nutrition) Food and Nutritional Sciences (Food Science) Department of Natural Resources and Environmental Design Biological Engineering (Bioprocess Engineering Track) or (Natural Resources Engineering Track) Agricultural and Environmental Systems (Environmental Studies) Agricultural and Environmental Systems (Sustainable Land Management) Agricultural and Environmental Systems (Urban & Community Horticulture) Landscape Architecture Students: Please print your application, and have your school s guidance counselor complete the remainder of the form. I CERTIFY THAT ALL THE INFORMATION I HAVE PROVIDED ON THIS APPLICATION IS TRUE, COMPLETE AND ACCURATE. Date Signature of Applicant
5 COUNSELOR INFORMATION: This section is to be completed by the applicant s high school counselor: * Only rising juniors and rising seniors with GPAs of a minimum 2.8 are eligible. Please type or print legibly. Student s Name _ Name of high school Street address _ City State Zip School telephone ( ) - Classification: Rising junior Rising senior Expected graduation date (Month Year ) Cumulative GPA Class Rank Class size Indicate the date(s) applicant took, or plans to take, the following tests and test scores where applicable. TEST MONTH/YEAR SCORE MONTH/YEAR SCORE American College Test (ACT) Scholastic Aptitude Test (SAT) SAT Achievement Test(s) Other, Specify_ Counselor s name (type or print legibly) Counselor's signature North Carolina A&T State University is committed to equality of educational opportunities and does not discriminate against applicants, students, or employees based on race, color, national origin, religion, sex, age or handicap.