PAN 2008 Student Application

July 21 - 25, 2008

Michigan State University


| PAN Home Site |


Information about you

First Name:

Last Name:

Email:

Phone:

Home address street:

City: State: ZIP:

Age:  

Birthday:      

 

Gender (optional):   Male   Female

US Citizenzhip:   Yes   No

Information about your school

School Name:

School District:

   

School Phone:

School address street

City: State: ZIP:

Information about your background

Grade Level Next Fall:

Please list all classes in science and math you have taken. Note that there are no required courses for this program.


Please give a brief listing of previous work experience, including the dates worked, the employer and a job description.


Please list any other experience you have which you feel make you a good candidate for this program.


Please state briefly why you are interested in the PAN program. You can also
send your personal statement to PAN, or e-mail it separately.


Letters of reference

Please have one science or math teacher and one teacher of any subject write a brief letter of reference to PAN. These letters of recommendation may be directed to PAN by U.S. post, by e-mail, or by telephone (see Contact PAN for addresses). Please list the names of the teachers who will be writing the letters for you.

First teacher's name

School

Second teacher's name

School

Accommodations

Do you plan to stay on campus?

Yes No

If no, please tell us how you will get to MSU and where you will stay.

Survey

How did you first learn about the PAN program?

Poster        The PAN website

Another website (please specify):      Other (please specify):