Section 1 General Information

Name

Choose appropriately

African American Hispanic Native American

Date of Birth

E-Mail Address

Home Address

Street Number  

City 

State 

Zip Code 

Home Telephone

Name and Address of Parent or Guardian (if different)

Street Number  

City  

State 

Zip Code 

Home Telephone

Section 2 Academic Information

High School Name

High School Telephone

Have you ever attended a summer program?

If yes, what program and when did you attend?

Recommendations: Please ask at least two persons who know you well, but are not relatives, to send letters of recommendation to:
 

One recommendation must be from a recent math or science teacher. Applications will not be considered complete without these. Incomplete applications will not be reviewed. It is the student's responsibility to make sure that both sides of this application are completed and handed in with the sheet of four questions, high school transcript, including sophomore mid-year grades, and both letters of recommendation.

List the Names and Telephone Numbers of two people who will write recommendation letters for you.

A. Name: Phone number:

B. Name: Phone number:

Section 3 Engineering Disciplines

While at Rutgers University, the TEEM students will be exposed to several fields of Engineering. In order to participate, students must indicate which of the following fields of engineering they are mostly interested in. Please number in order of preference, please mark your first choice with a 1, second with a 2, etc. Make sure you mark all six fields of Engineering.

Electrical and Computer Engineering      

Civil and Environmental Engineering        

Chemical and Biochemical Engineering    

Mechanical and Aerospace Engineering  

Ceramic and Fiber Optic Engineering      

Biomedical and Bioresource Engineering  

Section 4 Essay

Please provide in an essay format, the answers to the following questions:

What field of engineering interests you the most, if any at this time, and why? (150 words max)

State briefly your achievements in school, including extracirricular activities and any honors or recognition you have received.

List any employment held (most previous employment first) company, dates, and duties.

How do you expect to benefit by participating in this program.