Providing Experiences in Research for Undergraduate Students in Engineering (PERUSE)

Date:

First Name:

Last Name:

Classification: Choose your classification: Freshman Sophomore Junior Senior

Please choose your undergraduate major: Choose your major: Aerospace (Aer E) Agricultural (A E) Biological Systems (B S E) Chemical (Ch E) Civil (C E) Computer (Cpr E) Construction (Con E) Electrical (E E) Industrial (I E) Materials (Mat E) Mechanical (M E) Software (S E)

Minor in College:

Cumulative Iowa State GPA:

If you are a senior, when do you plan to graduate?

Email:

Address (local):

City (local):

State (local): Zip (local):

Phone Number (local):

Cellphone:

Are you a U.S. citizen? Yes     No

Are you work-study eligible? Yes     No
(via financial need through Student Financial Aid)

Are you interested in summer employment? Yes     No

How did you learn about PERUSE?

Please list your research project interests and we will seek available matches:

Prior research experience:

Are you a member of the Honors Program? Yes     No

Reference 1 (Name, Phone, Email, Position/Title):

Reference 2 (Name, Phone, Email, Position/Title):

Submit a resume
Browse your computer and ATTACH a Word document or PDF only. (5MB max. size) Do not copy and paste into this form field.