Last name:   First name

Full (name@hc.edu or bmc.edu) email address:  

Class year: Major(s):

Minor(s) and Concentration(s) if applicable:

Do you plan on studying abroad next year? If so, which semester?

Would you like to be considered for the Beckman Scholarship? [This award involves two summers of research with a Haverford mentor and provides an opportunity for you to attend the Beckman conference in California.  You must submit a separate application for the Beckman Scholarship. Please see more information about this program here.]
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For the following questions, the recommended length is no longer than what shows in the text area at one time (without scrolling). (View this as a loose guideline, not a rigid requirement).

Please give thoughtful and articulate answers to the following questions:

1) Describe an interdisciplinary research question that you have encountered in a course, your reading or lab work that has sparked your interest. This does not have to relate to the work you may do as a Scholar, but should reveal your understanding of and interest in interdisciplinary science.

2) How is an interdisciplinary approach useful or essential to answering this research question?

3) Why does this research question appeal to you?

4) Please list the names of at least 2 faculty members with whom you would be interested in working in order of preference. You must speak to these faculty members about working in the lab this summer before listing their names.

	Faculty name	I have spoken with this faculty member
1)		Yes No
2)		Yes No
3)		Yes No

Current Scholars: Please provide an abstract of your summer's research. This can be from the poster you presented at the Undergraduate Summer Research Symposium from last fall. To this, please add a brief reflection on how this experience has influenced your academic and career goals. You can enter this in the space below or email it to kheston@haverford.edu.

Proposed Coursework Form

On this form, please indicate the classes (title and number) you have taken and plan to take to fulfill the HHMI Scholars course requirements.  Refer to the Academic Requirements for the HHMI Interdisciplinary Science Scholars Program for details.

Which classes have you taken or plan to take to fulfill the course requirements for HHMI Scholars?
Please list these, including course title and number:

-Quantitative class

-At least four semesters of computer science and/or lab-based experimental science courses in two departments

-Advanced interdisciplinary science or math course outside of your major that fulfills the HHMI Scholars requirement:   (1 semester or 1 credit - please refer to the courses listed online.)

In addition to filling out this form and submitting it (click on the submit button below), you must send an unofficial copy of your current transcript (including courses in which you are currently enrolled) to Kate Heston (kheston@haverford.edu, KINSC S109, or by campus mail).

When you have completed the form above, print out a copy of this page for your records. Then click on this button: . You should get confirmation of your submission by e-mail within a day or so.

If you wish to clear the text boxes and fields above, press