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CIQM Summer School: 2021 Application Form
*
Indicates required field
Name
*
First
Last
Email
*
How did you hear about the CIQM Summer School? Please list all ways that apply, and include name of who recommended CIQM if possible.
*
Summer School Project Interests:
Describe your Research Interests
*
CIQM Online Course Offerings, Click all that Apply
*
An Introduction to Linear Algebra Using Python, Steven Richardson, May 18 - August 9, Tuesdays 2:00pm -3:35pm - optional one-hour recitation to follow
Brookhaven National Lab (BNL) Foundations in Quantum Programming, June 14 - July 9, M-F 8:30am - 4:30pm
American Sign Language Classes
Please check all that apply
Demographics
Will you be over 18 by May 16, 2021
*
Yes
No
Gender
*
Male
Female
Other
Race
*
White
Black
Asian
Native American
Pacific Islander
Mixed
Ethnicity
*
Hispanic
Non-Hispanic
Family History (optional): What is the highest level of education obtained by your parent(s) or legal guardian(s)?
*
Citizenship Category
*
United States
Permanent Resident
Non US Attending University
Citizenship Country
*
Are you a Dual Citizen?
*
Yes
No
Disability (optional)
*
Yes
No
If yes, what is your disability?
*
Military Background (optional): Are you a Veteran or an active member of the United States Military (including reserves)?
*
Yes
No
Education History
Current Institution
*
Enroll Date:
*
Approximate Graduation Date:
*
What is your last exam date for the spring semester?
*
Have you attended any other institutions?
*
If so, please list name of Prior Institution 1:
*
Date Attended From:
*
Date Attended To:
*
GPA
*
Prior Institution 2
*
Date Attended From:
*
Date Attended To:
*
GPA
*
What Year are You?
*
Freshman
Sophomore
Junior
Senior
Major
*
GPA
*
What is the highest level of degree awarded in Science/Engineering at your school?
*
High School Name:
*
City, State:
*
Date Attended From:
*
Date Attended To:
*
GPA
*
Scholarships, Honors, and Awards
Please list briefly any significant scholarships, honors, or awards you have received․
*
Skills
Please list briefly any skills relevant to research such as computer languages or machine shop experience․
*
Research and Work Experience
Do you have prior Research experience?
*
Yes
No
Do you have prior Work (or Military) experience?
*
Yes
No
Work Experience Details
Prior Employment #1
Employer
*
Date Employment From:
*
Date of Employment To:
*
Supervisor(s):
*
Description:
*
Prior Employment #2
Employer
*
Date of Employment From:
*
Date Employment To:
*
Supervisor (s):
*
Description:
*
Resume/CV (Optional)
*
Max file size: 20MB
please upload your Resume/CV as a pdf
Contact Information
Phone Number
*
Permanent Address
Street
*
Apt or Unit
*
City
*
State or Province
*
Zip Code
*
Country
*
Is your permanent address the same as your mailing address?
*
Yes
No
Research Statements
Research Statement:
*
Personal Statement
Personal Statement:
*
Transcript
Upload Your Transcript
*
Max file size: 20MB
Recommendations
Upload a File with your Letter(s) of Recommendation
*
Max file size: 20MB
Submit
About
Overview
Participants
Tri-Fold Brochure
News & Events
Calendars
News
Events
>
FQMD 2022
Site Visit 2022
2021 Annual Meeting
2020 STC Directors Meeting
2020 Tohoku Workshop
2019 Annual Meeting
FQMD 2019 Frontiers in Quantum Materials and Devices
Quantum Matters Competition
>
Quantum Matters Competition 2019
Quantum Matters Competition 2018
2018 Annual Meeting
2017 Annual Meeting
FQMD 2018 Frontiers in Quantum Materials and Devices
FQMD 2017 Frontiers in Quantum Materials and Devices
Retreat 2016
>
Retreat General Info
Registration Retreat 2016
Frontiers in Quantum Materials and Devices Workshop 2016
Frontiers in Quantum Materials and Devices Workshop 2015
>
FQMD General Information
Registration
Annual Meeting 2016
>
2016 General Info/Agenda
Micro-presentations Abstracts
Undergraduate Poster Abstracts
Annual Meeting 2015
>
2015 Agenda
General Info / Logistics
Poster Formatting
2015 Poster Abstracts
2015 Micro-Presentation Abstracts
Annual Meeting 2014
>
2014 General Info / Agenda
Micro-Presntation Abstracts
Poster Abstracts
Images
Highlights
Online Community
Overview
OC-Calendar
Online Courses/Workshops
Professional Development
Fun Activities
Education
Overview
Summer School
Academic Year Internships
Course Modules
Museum of Science, Boston
>
Overview
Live Presentations and Events
Educational Resources and Media
Science Communication Workshops and Internships
Sharing Science Workshop & Practicum
David Macaulay Studio
Ethics Training
Quantum Express
Research
Overview
Research Areas
Seminars
>
Quantum Materials and Devices Seminar
BACON+ Seminar
Research Exchange Seminar
Publications
Facilities
Knowledge Transfer
Overview
Industry Partners
iLab
CIQM You Tube Channel
CIQM Comic Book
Resources
Frequently Asked Questions
Glossary of Terms
Harassment Policy
Center Logo
Wiki
Tumblr
Poster Formatting