AN INTENSIVE SUMMER ACADEMY IN MATHEMATICS, SCIENCE, AND TECHNOLOGY
LANGSTON UNIVERSITY, LANGSTON, OKLAHOMA
To The Applicant: Please type this application. Be sure to attach two letters of recommendation on school stationary from a high school mathematics and science teacher. Also, provide a current transcript. Applicant must be a student entering his/her sophomore, junior, or senior year of high school in the Fall of 2007.
Application Deadline: April 16, 2007.
APPLICATION FORM
Name:
Last
First
Middle
Mailing
Address:
Street
City
State
Zip Code
Telephone #:
Social Security #:
U.S. Citizen:
Sex:
Date Of Birth:
Ethnicity:
Parent or Guardian
Name in Full:
Last
First
Middle
Address:
Street
City
State
Zip Code
High School:
City, State:
Math Courses in 9th , 10th , and 11th grades
(Letter grades for first and second semester)
Course
Grade
Course
Grade
9th
10th
11th
Science Courses in 9th , 10th , and 11th grades
(Letter grades for first and second semester)
Course
Grade
Course
Grade
9th
10th
11th
List 1st , 2nd , and 3rd choice
of areas preferred for research
First Choice:
Second Choice:
Third Choice:
Mail to arrive no later than April 16, 2007 to:
Dr. Alonzo F. Peterson, Director
Intensive Summer Academy in Mathematics, Science, and Technology
Department of Mathematics
P. O. Box 1500
Langston University
Langston, Oklahoma 73050
