Summer Research Fellowship for Minority Undergraduate Students

Application Deadline: March 1

Last Name:
First Name:
Middle Initial:
Date of Birth:
Email:
Permanent Mailing Address:
City:
State:
Zip:
Permanent Day Phone:
Permanent Evening Phone:
Current Mailing Address:
City:
State:
Zip:
Current Day Phone:
Current Evening Phone:
Sex: Female    Male   
Are you a U.S. Citizen?: Yes    No   
Ethnicity: African American    Hispanic/Latino
Native American    Puerto Rican   
Other
If other please specify:
Current Status: Freshman    Sophomore    Junior    Senior   
Current Major/Minor:
Anticipated date of graduation:
Overall GPA (on a 4.0 scale):
In major GPA (on a 4.0 scale):
Information about you: urban/rural/suburb?:
First generation college student?: Yes    No   
First generation STEM college student?: Yes    No   
Multicultural experience and skills?:
Barriers you have overcome to be a college student?:
Ag related leadership?:
Non-ag related leadership?:
Scholarships, honors, prizes or other recognition:
Memberships in honor societies or other organizations (include high school and college):
Extracurricular activities, volunteer activities:
Prior employment experience:
I certify that the information stated in this application is correct and complete: Yes
FAHRP  -  The Ohio State University  -  OARDC  |  1680 Madison Ave, Wooster, Ohio  |  Phone: 330-263-3744
© 2008 The Ohio State University