Application for a Summer Research Stipend

Clarkson University » Honors Program » Research

* required

Full Name *	Student ID Number
Graduation Year	CU Box Number
E-mail
Major	Research Advisor
Research Project Title
Briefly describe your reasons for applying for a summer research stipend.
What do you plan to accomplish during the summer?
Clarkson Community Participation Please include dates, positions held and advisor name
Clarkson Athletic Participation Please include dates, honors/awards and coach's name
Honors or Awards since enrolling in Clarkson
Work experience since enrolling in Clarkson Please include employer, dates, position held, supervisor name
Please list at least two references
Reference 1
Name
Address
Phone
Affiliation
Reference 2
Name
Address
Phone
Affiliation