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National Nuclear Chemistry Summer Schools

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Prof. J. David Robertson, Director
ACS Nuclear Chemistry Summer Schools
Department of Chemistry
University of Missouri
Columbia, MO 65211
Email: robertsonjo@missouri.edu
FAX: 573-882-2754


National Nuclear Chemistry Summer Schools Application Form

Personal Information
Last Name: First Name:
Sex: Male Female
Current Address: Permanent Address:
City: City:
State: State:
Zip/Postal Code: Zip/Postal Code:
Phone: Phone:
Fax:
E-mail:
Birthdate (MM-DD-YYYY):
Place of Birth (City, State): Country of Birth:
U.S. Citizen: Yes No
(Applicant must be a U.S. citizens to qualify for this program)
Academic Information
School Presently Attending:
School Location:
Major:
Expected Graduation Date:
Current Status:
Current GPA Science GPA
SAT or ACT Scores Verbal Math
Have you taken or are now taking Physical Chemistry? Yes No
Have you taken or are now taking Physics? Yes No
Honors and Awards
Program Information
If selected for this program, what is your site preference?
Eastern Western None
Do you want college credit? Yes No
If no, please explain
How did you learn about this program?
Interests and Educational Goals
Describe you interest in, and how you would benefit from, this program (Please limit to less than 200 words)
Describe your educational and career goals (Please limit to less than 200 words)

By selecting the submit button, I certify that the above information is accurate and understand that any misrepresentation may be cause for refusal of admission to the program