Wesleyan HHMI Summer Outreach (WHSO) for Visiting Students

FELLOWSHIP APPLICATION 2012

Please be sure to complete the Application Supplementary Questions before filling out the form below. It can be uploaded at the bottom of this form.

First Name:
Last Name:
Email Address:
Phone:
Class:
Major:
University/College:
Home Address:
Are you a citizen of the US?:	YesNo
If not, do you have a green card?:	N/AYesNo
First letter of recommendation will be from:
Second letter of recommendation will be from:
Upload your Application Supplementary Questions here:
I understand that this is to be my full-time commitment for the ten weeks of the Hughes Summer Program. I further agree that, in accepting funds from the Hughes Program, I will not accept other funds for this or other work during the ten weeks, without prior authorization from the director of the Hughes Program, and that such authorization is rarely given.
Electronic Signature:
Please arrange for a current transcript and two letters of recommendation from faculty to be sent to: Wesleyan HHMI Summer Outreach Program, MB&B Department, Wesleyan University, Middletown, CT 06459.