Name:
E-Mail:
Class:
SU Address:
Phone Number:
Williams ID:

List the faculty members in whose labs you would like to do research in order of preference. List as few or as many faculty members as you wish, but make sure that every faculty member you list is one that you have spoken with and you would like to have as a research mentor. You should also be aware that it is often impossible to place all students with their first choice. If you only list one faculty member and the department cannot place you in that lab, you will then need to consider slots that remain available in other labs. (If you want to leave a field blank, just type in a space or hyphen.)






Please explain your reasons for listing the faculty members you have chosen, and indicate how and why you might rank those labs in terms of preference.


List the names of one or two faculty members who can speak to your science experience:

Indicate what range of dates you would be available to work during summer 2010 (choose a date range within the ten week period June 14 to August 20, the final day for college housing) and indicate the number of weeks (maximum 10 weeks) within that date range you would like to work (you can indicate a range such as 8-10 weeks, or 4-6 weeks). This information will give faculty flexibility in determining a start and end date for your summer experience.

Use this space to list any previous work experience you've had in college or high school (scientific or non-scientific, volunteer or paid, ...).

Use this space for any other comments or information you would like the department to know: