2006 BECKMAN SCHOLARS PROGRAM APPLICATION Carnegie Mellon University

Please type or print legibly in ink. Include with the completed application: (i) a Carnegie Mellon transcript showing Spring 2006 midterm grades, and (ii) a statement of purpose describing your research interests and career goals, your past research experience and accomplishments, and your research plans (background, goals, and methods). In addition, letters of support should be submitted by two faculty members directly to the program.

Completed materials should be received by March 20, 2006.

1. Name_______________________________________ Soc. Sec. No.___________________

2. Campus Address _________________________________________________

_______________________________________________Telephone (_______) ____________________

3. Permanent Address _______________________________________________

_______________________________________________Telephone (_______) ____________________

Email ______________________________________________________________

4. Current Academic Status: Sophomore __________ Junior __________ Expected Graduation Date: __________

5. Major _____________________Minor/Option/Track (if any) _____________________

6. Academic History (include Academic Honors and Awards):

College (s) attended since high school graduation Date entered
(month/year) 		Date left
(month/year) 		Academic Honors or Awards Received
    
    
    
    


6. Names of the two faculty members whom you have asked to write letters of recommendation.




If chosen as a Beckman Scholar, I agree to participate fully in the activities of the Program, including engaging in two summers of full-time research (2006 and 2007) and one academic year of part-time Honors research.


Signature ____________________________________________________________ Date ______________

Please send this application and supporting material to:

Dr. A. Javier Lopez
Mellon Institute Box 156
Carnegie Mellon University
4400 Fifth Ave.
Pittsburgh, PA 15213