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Space Grant Internship Application Form

The University of Arizona/NASA Space Grant
Undergraduate Research Internship Program
Intern Application 2010-2011


Application Deadline: July 2, 2010

The University of Arizona/NASA Space Grant undergraduate research internship program is intended to provide a paid research-work experience for undergraduate students that can also help develop professional/career interests or aid in developing an understanding of scientific work. The program is specifically not limited to science and engineering students, although US citizenship is required. A few opportunities involve researching and writing about science history or national policies. The internship program seeks to provide research opportunities for science and engineering students, as well as for those students whose career plans will ultimately take them in other directions. Applications are especially encouraged from members of under-represented minority groups and from women. You must have at least Sophomore standing in the Fall semester at either the University of Arizona or Pima Community College in order to apply.

First Name
Last Name
Date of Birth
(MM/DD/YY)
Major Department
Student ID #
University E-mail Address
Permanent Email Address
(Non University Email)
GPA (X.XX)
Academic Standing
(Fall Semester)
Projected Graduation Date
(MM/YY)
College or University that you attend
How did you learn about the Space Grant Undergraduate Research Internship Program?
Demographic Information
(optional)

Parent Contact Information:

First Name Last Name
Street
City State Zip
Phone
XXX-XXX-XXXX

Local Address:

Street
City State Zip
Local Phone
XXX-XXX-XXXX
Mobile Phone
XXX-XXX-XXXX

Please list a faculty reference:

Name
Department
Phone
XXX-XXX-XXXX

If you have participated in any other NASA Programs please list them below.

Please briefly describe your academic background, experience, and job skills.

Please briefly describe your educational goals and career interests:

Please describe why the UA/NASA Undergraduate Research Internship Program is particularly suited to your needs and interests. What can you expect to gain from it? What can you contribute to the program that is special?

Please rate your interests:
Aerospace and Mechanical Engineering:
Agriculture/Resource/Environmental Economics:
Anthropology/Rural Sociology/Geography:
Astronomy:
Biology:
Chemistry:
Computer Science:
Ecology:
Electrical Engineering:
Environment Science/Global Change:
Journalism:
Optical Sciences:
Physics:
Planetary Sciences:
Rangeland Management/Science:
Remote Sensing and Spatial Analysis:
Soil Science:
Space Biology:
Science Education:
Space Science and Society, Policy:
Terrestrial or Planetary Atmosphere/Climate:
Terrestrial or Planetary Geology:
Water and Watershed:

I can commit to working hours per week.

I can work off-campus:

Previous project or research experience. A project might be a technical term paper, a semester job in a technical, scientific or engineering field, etc.:

Computer Experience:
Macs:
Windows:
UNIX:
Fortran:
C, C++:
Database:
GIS:
GPS:
HTML:
Java:
Visual Basic:
Image Processing:
Statistics:
MATLAB:

What other skills or talents do you possess that might help us evaluate your candidacy for an internship or better match you with a project (no more than three one-word answers):

Interns are generally matched with mentors/projects by the Space Grant Steering Committee. To request a specific mentor, please name him/her here:
If the Space Grant Steering Committee is unable to match you with the above named person, do you want to be considered for other positions?
Note: if you propose to work with a specific mentor, that mentor must submit a Mentor's proposal/application form to the Space Grant Steering Committee.

Tracking Agreement

A key measure of UA/NASA Space Grant Undergraduate Research Internship Program success is made through tracking the accomplishments and whereabouts of program participants. As a federal grant program, continued support and funding requires documentation of program accomplishments; tracking results must be provided to NASA and ultimately to Congress. To accomplish this, to apply for an Internship you must agree to the following:

If selected for UA/NASA Space Grant Undergraduate Research Internship, I agree to keep program managers apprised on my current academic accomplishments and personal whereabouts including my current contact information. In addition, during the internship I agree to complete program evaluation forms in a timely manner, and complete subsequent (online) program tracking forms at least one time per year starting at the end of my internship, until such time as I leave UA, complete my current UA/Pima academic degree, and can document the "next step" in my academic or professional activities (i.e., enter graduate school or the workforce).



If you desire a record copy of your completed application form, check the box below. A copy will be sent your e-mail address indicated above. In addition, we recommend that you print a copy of the completed form, for your records, before you submit it.

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