Undergraduate Student Travel Award Application
Application deadline is MARCH 7, 2012
ALL INFORMATION REQUESTED IS REQUIRED.
General Information
Full Name::
Last Name
First Name
M.
Gender::
Female
Male
Birth Date (MM/DD/Year)::
(12/02/1990)
Notification Address::
(No & Street/PO Box)
City::
State::
Zip/Postal Code::
Cell Phone Number::
Alternate Phone::
Email Address::
Alternate Email::
Permanent Address::
(No & Street/PO Box)
City::
State::
Zip/Postal Code::
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:
Where did you FIRST find out about SEEDS?
(check only ONE)
Web search
Direct email from ESA/SEEDS
SEEDS chapter
Participated with SEEDS before
Communication from a former faculty/professor/advisor
Communication from a former SEEDS participant(specify):
At a conference/meeting
(specify):
Other organization website/listserv/bulletin board
(specify):
Academic Information
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::
Minor/Concentration::
Faculty Advisor Name::
Advisor Phone::
Email::
Meeting Information
Have you submitted or do plan to submit an abstract to present research at the 2010 ESA Annual Meeting?
Yes
No
If yes, please provide abstract number and/or abstract of research for presentation:
Statement of Interest
In a minimum of 500 words: (1) describe why you want to attend the ESA Annual Meeting, considering your educational and career goals and interest in exploring or pursuing a career in ecology; (2) summarize your ecology experience thus far (SEEDS activities, coursework, research or work experience, etc.); (3) share your role (past, present, future) as an educator or mentor and how your participation in the ESA Meeting may benefit or impact others; and, (4) describe how your participation at the ESA Meeting would meet the SEEDS mission.
Personal Statement:
Resume
Paste a resume below. Include relevant research experience, coursework, employment and awards, honors, and scholastic achievement.
Resume:
Or, send your attached resume to
References
Full Name
Phone
Email
Applicants' Certification
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.