APPLICATION FOR THE 2015 SUPER SCHOLARS PROGRAM (Summer Undergraduate Program of Entrepreneurship and Research)

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The Donaghey College of Engineering and Information Technology The University of Arkansas at Little Rock Little Rock, Arkansas 72204

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Highlights of the Application Process Students applying to the program will be required to do so electronically. A committee is charged with the review of applications and selection of the SUPER scholars. The selection of the scholars is a two-step process. In the first step, a shortlist of applicants is created. Applicants on this short list will be interviewed on Skype. Based on this interview and the submitted application, the second step will determine the list of applicants to whom offers will go out. Applicants will have two weeks to respond to the offer with a written acceptance. Failing to do so will forfeit the offer.

Timelines i. January 31: Deadline by when applications need to be submitted to receive full ii. iii. iv.

consideration. Applications will continue to be accepted after January 31. February 23: Shortlisted applicants will be interviewed on Skype during the week of February 23. They will be contacted in advance. March 9: Offers will go out during the week of March 9. March 23: Applicants to whom offers have been sent out will need to communicate their acceptance by this date, in absence of which they will forfeit the offer.

*****DATES FOR THE PROGRAM***** May 26, 2015 to August 5, 2015 Mid-program Break: July 3 to July 6, 2015

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To receive full consideration, applications will need to be submitted by January 31. Applications will continue to be accepted after January 31.

Contact Information Last Name: Gender:

First Name: F

Ethnic Information:

MI:

M American Indian/Alaskan Native Black/African American Caucasian/White Other

Email Address:

Asian/Pacific Islander Hispanic/Latino Puerto Rican

Contact Phone No:

Mailing Address:

Academic Background University name: Major: Credit Hours completed in major: Hours remaining prior to graduation in major: Current Cumulative GPA (preferred 3.25 or higher):

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Prior Research Experience including participation in SURF (Summer Undergraduate Research Fellowship) of the Arkansas Department of Higher Education or any other funded research project (1 page or less):

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Personal Statement: Describe your motivation/interests in research and pursuing graduate studies (1 page or less):

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Are you interested in being an entrepreneur after completing your university education? Describe your thoughts, as well as any experience you may have acquired (1/2 page or less):

Are you interested in pursuing your own project, supervised by a mentor? Provide appropriate justification including potential for commercialization (Use additional pages if needed):

Will you need free, shared on-campus accommodation? 6

YES

NO

Contact Information of Three Academic References Provide contact information of three references who are familiar with your academic and/or research and/or entrepreneurial experience. We may contact them if needed.

1. Name: Telephone: Email: Affiliation: Relationship to Applicant: 2. Name: Telephone: Email: Affiliation: Relationship to Applicant: 3. Name: Telephone: Email: Affiliation: Relationship to Applicant:

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Choice of Research Projects (Select five projects of your choice and rank them in order of preference)

Rank

Project Number

1 2 3 4 5 ***If you have submitted a project, we will give it due consideration along with the above ranked projects***

Signed Statement by Applicant By signing below, I state that (i) (ii) (iii)

(iv) (v)

I am a US citizen or permanent resident. If I am selected to be on the shortlist, I will participate in the Skype interview. I understand that without participating in the interview, I will be ineligible for the SUPER program.1 I understand that the program requires full time commitment and during the duration of the program, I will not engage in any other employment, take summer courses or go on vacation. I also understand that the program will have a mid-program break from July 3 to July 6, 2015. I understand that if I am selected for the program, I will need to submit official transcripts. I have the skill sets for the projects that I have chosen.

Signature of Applicant

Date

_______________________________________________

____________________________________________

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The applicant is advised to have a Skype ID available by early February, 2015 to share with the program organizers if they request it.

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Email application and one set of unofficial transcripts to: [email protected] by January 31, 2015 to receive full consideration.

CONTACT PERSONS Dr. Abhijit Bhattacharyya Associate Dean, EIT University of Arkansas at Little Rock 2801 South University Avenue, EIT 626 Little Rock, AR 72204-1099 (O) 501.683.7117 (F) 501.569-8002 [email protected] Mrs. Dana Ball Academic Support Specialist, EIT University of Arkansas at Little Rock 2801 South University Avenue, EIT 631 Little Rock, AR 72204-1099 (O) 501.569.3285 (F) 501.569.8002 [email protected]

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