Last Name First Middle ID Number. Street address City State Zip

(1)

______________________________________________________________________________

Application for the USDA-HSI Research Experiences for Undergraduates Programs

Terrestrial Ecology Research Lab, Department of Biological Sciences, California State University, 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:

LastName First Middle IDNumber

Street address City State Zip

Telephone E-mail Major(s)

Reference contact information: Please provide names of two people who could serve as references. Reference 1

Last Name First Telephone E-mail

Reference 2

Last Name First Telephone E-mail

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

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Terrestrial Ecology Research Lab, Department of Biological Sciences, California State University, 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.

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Terrestrial Ecology Research Lab, Department of Biological Sciences, California State University, 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 • 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) Year 2 _•

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.

Year 3 _• _{Participation in the CSUSM MARC and/or RISE programs.} and

• Continued mentoring and support for degree completion. beyond

For more information, contact Dr. George Vourlitis

Department of Biological Sciences Science Hall 1- Room 320

California State University San Marcos, CA 92096, USA Phone: 760-750-4119 Fax: 760-750-3440

Email: georgev@csusm.edu

http://www.csusm.edu/terl

Completed applications must be returned to: Dr. George Vourlitis

Department of Biological Sciences Science Hall 1- Room 320

Email: georgev@csusm.edu

OR

Ms. Rita Cooper

Office of Biomedical Research and Training Academic Hall- 410

Email: rcooper@csusm.edu

(4)

Environmental Science

Course: ______________ Semester: Fall Spring 201__

This short survey is designed to assess student interest and familiarity with the field of environmental  science. Completing the survey is voluntary, and your responses will be used to inform the environmental  sciences curriculum. Completing the survey will take about 5 minutes, and your responses will be completely  anonymous.  Questions about this survey should be directed to Professor George Vourlitis  (georgev@csusm.edu) or to the campus IRB office at 760.750.4029.       1.   Current Cumulative GPA: _________   

2. Class Standing: (circle one)    Freshman  Sophomore     Junior   Senior 

  3.   Did you transfer to CSUSM from another college or university?    Y     N      If YES, what was the name of the school? __________________________________________________      ON A SCALE FROM 0 (NOT AT ALL) TO 10 (A GREAT DEAL)……  (0 = not at all)      (10=a great deal)  4. ….. which best describes your interest in pursuing a  bachelor’s degree at CSUSM in environmental science?  (circle  _{0       1       2       3       4       5       6       7       8       9       10} your response)    5. …. which best describes your interest in pursuing a career in  environmental science?  0       1       2       3       4       5       6       7       8       9       10    6. …. which best describes your interest in conducting research  in the field of environmental science?  0       1       2       3       4       5       6       7       8       9       10    7. …. which best describes your interest in attending a  0       1       2       3       4       5       6       7       8       9       10  graduate program in environmental science?  ON A SCALE FROM 0 (NOT AT ALL) TO 10 (A GREAT DEAL)……  (0 = not at all)      (10=a great deal)  8. ….how knowledgeable are you about the field of  environmental science?   0       1       2       3       4       5       6       7       8       9       10    9. ….how knowledgeable are you about the career  opportunities in environmental science?  0       1       2       3       4       5       6       7       8       9       10    10. If you wanted to, how confident are you that you could  complete a bachelor’s degree in environmental science?  0       1       2       3       4       5       6       7       8       9       10    11. If you wanted to, how confident are you that you could  0       1       2       3       4       5       6       7       8       9       10  obtain a job working in the field of environmental science? 

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      12. Have you ever participated in a science training program? (check all that apply)   

❑

 MARC   

❑ 

MBRS‐RISE   

❑

 Bridges   

❑

 Luis Stokes AMP   

❑

 Other (specify)__________________________________________________________________    _____________________________________________________________________________________      13. This semester, are you involved in any research activities?  

❑

 No   

❑

 Yes, as part of a laboratory course    

❑

 Yes, as a paid position    

❑

 Yes, as part of an independent study activity with a faculty member   

❑

 Yes, other (please describe)____________________________________________________________    _____________________________________________________________________________________      14. Is there a faculty member that you would consider a mentor? (A mentor is someone who provides  guidance, assistance, and encouragement on professional and academic issues).  

❑

 No   

❑

 Yes (describe):                            15.  During the current academic term, approximately how many hours per week do you plan to work for pay?      ___________ (hours)    

16.  What is your sex?  

❑ 

Male     

❑ 

Female 

  17.  Are you of Hispanic, Latino, or Spanish origin?   

❑

 No   

❑

 Yes    18. With which of the following racial groups do you identify (check all that apply)   

❑ 

White   

❑ 

Black or African American   

❑

 

American Indian or Alaska Native   

❑ 

Asian (including Asian Indian, Chinese, Japanese, Korean, or other Asian)     

❑ 

Other (Specify):____________________________________________      (THANK YOU) 