SEEDS » Programs » Annual Meeting » Apply
Alumni Travel Award Application
Application deadline is MARCH 7, 2012
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 General Information | ||||||||||
| Full Name:: |
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| Gender:: | Female Male | |||||||||
| Birth Date (MM/DD/Year):: | (12/02/1990) | |||||||||
| Notification Address:: | (No & Street/PO Box) | |||||||||
| City:: | ||||||||||
| State:: |
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| Cell Phone Number:: |
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| Email Address:: |
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| Permanent Address:: | (No & Street/PO Box) | |||||||||
| City:: | ||||||||||
| State:: |
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| Permanent Phone No:: | ||||||||||
| If not a U.S. citizen, national or permanent resident alien, what is your country of citizenship? | ||||||||||
| Race/Ethnicity: |
Other:
If selected American Indian or Alaska Native, enter your Tribal Affiliation: | |||||||||
| Academic Information |
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| College or University:: | ||||||||||
| Class Standing :: | Freshman Sophomore Junior Senior | |||||||||
| Cumulative GPA:: | ||||||||||
| Anticipated Graduation Date:: | (Month/Year) | |||||||||
| Degree to be Obtained:: | (AA, AS, BA, BS) | |||||||||
| Major:: |
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| Faculty Advisor Name:: | ||||||||||
| Advisor Phone:: |
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| Meeting Information |
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| Have you submitted or do plan to submit an abstract to present research at the 2011 ESA Annual Meeting? | ||||||||||
| Yes No | ||||||||||
| If yes, please provide abstract number and/or abstract of research for presentation: | ||||||||||
| Statement of Interest |
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In a minimum of 300 words: (1) describe why you would like to attend the ESA Annual Meeting as a SEEDS alumni mentor, (2) share your role (past, present, future) as an educator or mentor and how your participation as an alumni mentor would benefit SEEDS undergraduates; and, (3) describe how your current career standing qualifies you to be an alumni mentor. | ||||||||||
| Personal Statement: | ||||||||||
| Resume |
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| Paste a resume below. Include relevant research experience, coursework, employment and awards, honors, and scholastic achievement. | ||||||||||
| Resume: |
Or, send your attached resume to 
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| References |
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| Applicants' Certification |
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| I have read and checked this form for omissions and errors. To the best of my knowledge, the information is complete and correct. I understand that the inclusion by me of false information or the failure to report all information requested in this application could disqualify me for further opportunities with the Ecological Society of America's SEEDS Program. | ||||||||||
| Agree to Terms? | Yes No | |||||||||
| Submit Date:: | (MM/DD/YEAR) | |||||||||
