***This application is not encrypted***

Application For

Summer Undergraduate Mathematical Sciences Research Institute (SUMSRI)

*Name:*	Date:
*Your Address at College:*
*Email Address:*
*Permanent Address:*	Street: City:
	State: Zip:
*Telephone Number(s):*	Local:
	Permanent:
Married? Yes No	U.S. Citizen or Permanent Resident? Yes No
*College Name:*	*Classification:* Freshman Sophomore Junior Senior
Projected Graduation Date:(mm/yyyy)	*Major:*
*GPA(s):*	Overall GPA:
	Major GPA:
Gender:female male	Ethnicity:
Is English the only language spoken at home?Yes No	Were you raised in a single parent home? Yes No
Did you attend public or private high school?Public Private	What is your parents' highest grade completed?4-8 9 10 11 12 13 14 15 16 16+
Is your high school rural, urban or suburban? rural urban suburban	Did you take AP courses in high school? Yes No If yes, how many?
	What was the last math course taken in high school?
*How did you hear about SUMSRI?:*	Website Professor Departmental newsletter/bulletin board National Meeting Fraternity/Sorority Other

Please list all your college level mathematics, statistics and computer science courses. Please be sure to include those courses you are currently taking.

Freshman Year	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
Sophomore Year	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
Junior Year	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
Senior Year	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*
	*Course*	*Author of Text:*	*Instructor:*	*Grade:*

Please explain your career plans and why you would like to participate in SUMSRI.

Please have two letters of recommendation and official academic transcripts sent to:

Vasant Waikar or Dennis Davenport
SUMSRI
Department of Mathematics and Statistics
Miami University
Oxford, OH 45056
or mailto: porterbm@muohio.edu

home