Faculty mentor's first name Faculty mentor's last name

Faculty mentor's email Faculty mentor's Academic Department Accounting and Finance African American Studies Anthropology Art Biology Broadcasting and Cinema Business Administration Chemistry and Biochemistry Classical Studies Communication Sciences and Disorders Communication Studies Consumer, Apparel and Retail Studies Dance Economics Education English Exercise and Sport Science Geography German, Russian and Japanese Studies History Hospitality and Tourism Management Human Development and Family Studies Information Systems and Operations Management Interior Architecture Liberal Studies Mathematical Sciences Medical Technology Music Nursing Nutrition Physics and Astronomy Political Science Psychology Public Health Education Recreation and Parks Management Religious Studies Romance Languages Social Work Sociology Specialized Education Services Theatre Women's and Gender Studies

Student first name Student last name

Student email Last four digits of student's SSN#

Current student mailing address (street, apartment #)

Student mailing city Student mailing zip code

In the Spring of 2007 the student will be a Sophomore Junior Senior    Student G.P.A. at time of application (minimum allowed is a 2.7)

Credit hours earned at UNCG at time of application

How many hours is the student enrolled in for Fall 2006 semester?

Projected Spring 2007 credit hours

Funding period Spring 2007

Title of project

Expected product (select as many as applicable)

Will the student be enrolled in other programs or courses related to this research (i.e., honor's project) Yes No

If yes please use the space below to differentiate the responsibilities for the this project versus that of the honor's project and/or other course, project