Engineering Undergraduate Research & University Scholars Application

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Applicant Information

First Name*

Middle

Last*

Gatorlink Email Address*

Enter Email Confirm Email

Cell Phone Number*

College*

Major/Department*

Credits Completed*

Expected Graduation Date (month, year)*

Gender*

Female

Male

Prefer Not to Respond

Ethnicity*

Check all that apply

African American/Black

Asian/Pacific Islander

Hispanic/Latino/Mexican/Puerto Rican

Native American Indian

White

Prefer Not to Respond

Are you a Florida Opportunity Scholar?*

Yes

Do you receive financial aid not including Bright Futures?*

Yes

List the Research Project Titles, Faculty Mentors and Terms you are interested in:

First Choice – Project Title*

First Choice – Faculty Mentor*

Second Choice – Project Title

Second Choice – Faculty Mentor

Second Choice – Term

Third Choice – Project Title

Third Choice – Faculty Mentor

Third Choice – Term

Statement of Understanding:*

I agree to complete the requirements of the University Scholars Program by the due dates, and if I do not complete the requirements, I will be put into repayment status (you will be required to pay back the money to UF) for the full $1750 disbursement amount. The funds will be disbursed as follows: $750 in the Fall semester and $1000 in January. I understand that the disbursement of the University Scholars Program stipend does not change any of the requirements or due dates of the program.

Authorization to Collect Information*

I certify that the information submitted in this form is mine, and I give permission for the Herbert Wertheim College of Engineering to use it for the purposes of undergraduate research and other academic endeavors. This constitutes an exception to any privacy holds that may exist on my record.

Engineering Undergraduate Research & University Scholars Application

Applicant Information

Herbert Wertheim College of Engineering

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