F
OR
H
IGH
S
CHOOL
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TUDENTS
(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.
P
ERSONAL
I
NFORMATION
Date of application ______/ _____/ ________
Name _________________________________________________________________
Street address
___________________________________________________________City ___________________________ State ____ Zip _________ Email: __________
____________________H
ome 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
Hispanic
Black (Non-Hispanic Origin)
Caucasian
Asian or Pacific Islander
Other
Sex:
Male
Female
IN CASE OF EMERGENCY CONTACT:
(Relationship to applicant: father, mother, guardian, etc).
A
CADEMIC
A
CTIVITIES
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): ____________________________________________________
P
OST
H
IGH
S
CHOOL
P
LANS
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 ____________________________ 1st Choice 2nd Choice 3rd 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).
Summer Research
I
NTERESTS
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
C
AREER
I
NTERESTS
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 www.ag.ncat.edu 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: 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.
___________________________ _________________________________________________________________
