Nebraska IMMERSE
Application Form for Summer 2014
June 9 - July 18, 2014
To apply, send all application materials to:
(Deadline: March 15, 2014)
A completed application consists of:
Professor Tom Marley
Nebraska IMMERSE
Department of Mathematics
203 Avery Hall
University of Nebraska-Lincoln
Lincoln, NE 68588-0130
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A completed copy of this form
3 letters of recommendation
A copy of current college transcript
A written essay
Resume/Vita (optional)
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Name __________________________________________________________________________________________________
Last
First
MI
Gender:
Male
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Female
Are you a US citizen or permanent resident?
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Yes
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No
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Present Address
Street ______________________________________________________________________________________________
City _____________________________________________State _________ Zip _________________________________
Phone: (
)________________________ email: ____________________________________________________________
Name of your College or University: _________________________________________________________________________
Major(s) ___________________________ Expected date of Bachelor’s degree: _______________________________________
Mo/Yr
Please be advised that acceptance into IMMERSE is conditional upon you being accepted into a graduate program in
Mathematics offering the Ph.D. degree for the Fall 2014 semester. Below, list the mathematics graduate programs you have
applied to for the Fall 2014 admission term.
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List the names and affiliations of your letter of recommendation writers:
Name: _______________________________Affiliation:___________________Email_______________________
Name: _______________________________Affiliation:___________________Email_______________________
Name: _______________________________Affiliation:___________________Email_______________________
Include a personal essay (typically 1-2 pages) stating why you wish to pursue graduate study in mathematics, what your career
goals are, and how you would benefit from participating in Nebraska IMMERSE.
Check appropriate box (Optional):
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Hispanic
Asian
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African American
Caucasian
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Native American
Other _______________
It is the policy of the University of Nebraska-Lincoln not to discriminate based on gender, age, disability, race, color, religion, martial status,
veteran’s status, national or ethnic origin or sexual orientation.
Name ____________________________________________________ DATE _____________________________