2008 On-line Application Form

(Faculty)

 

Personal Information:
  
 
Title:
 
Last name:
 
First name:
 
M.I.:
 
E-mail address:
 
Please re-enter your e-mail above address to confirm:
 
 
 
Current address at school:
  
 
Affiliation:
 
Street:
 
City:
 
State:
 
ZIP:
 
School phone number (incl. area code):
 
Home address:
  
 
Street:
 
City:
 
State:
 
ZIP:
 
Home phone number (incl. area code):
 
Country of citizenship:
 
 
 
Applicant background:
  
 
 
 
Have you ever participated in this program?



 
If yes, then please state when
 
and where
     
  You may cut and paste from a word processing document into the fields below if the information is plain text only
(no special characters or graphics). If you encounter an error submitting this application, these fields are the
most likely source of problems.
     
  Please list your educational background (including dates, places and degrees):
 
     
  Please describe your professional experience (including your present position):
 
     
 

Please provide a summary of professional and teaching awards, honors or other notable accomplishments:
 
   
  Please provide a summary of your teaching activities:
 
     
  Please provide a statement of research activities and publications
 
     
  Please provide a statement of your objectives and reasons for participating in the program.
Please indicate opportunities for (or progress of) inclusion of solid-state topics in curriculum development:
 
     
  Please indicate your preference for host laboratory (for a list, click here):
 
First choice:
 
Second choice:
 
Third choice:
     
 

References

  
  Two references are required. It is your responsibility to contact your references and request that
they endorse your application. If you are a previous participant in the program, one reference must be
from a representative of a previous host laboratory.
 
Reference #1:
  
 
Title:
 
First name:
 
Last name:
 
Affiliation
 
Street address:
 
City:
 
State:
 
ZIP:
 
Telephone number (incl. area code):
 
E-mail address:
 
 
 
Reference #2:
  
 
Title:
 
First name:
 
Last name:
 
Affiliation:
 
Street address:
 
City:
 
State:
 
ZIP:
 
Telephone number (incl. area code):
 
E-mail address:

 

Important! Please review your application now.

Do NOT press the 'Submit' button until the form has been COMPLETELY filled out.