Colorado School of Mines s1

July 15 - July 22, 2014 Colorado School of Mines Golden, Colorado

Application

The American Chemical Society Summer School on Green Chemistry & Sustainable Energy will be held July 15 to July 22, 2014 at the Colorado School of Mines in Golden, Colorado. The program is open to graduate students and postdoctoral scholars from the United States, Canada, and Latin America who wish to use science to address relevant global challenges.

You must be able to be onsite from Tuesday, July 15, 2014 to Tuesday, July 22, 2014, arriving no later than 4:00 PM local time on opening day, to be considered for the school. There are NO program fees. Transportation, on- campus housing (a same-gender roommate will be assigned), and meals will be provided.

If you are selected as a participant, expect to hear presentations by leading researchers, collaborate on projects, participate in laboratory experiments, discuss the role of science and technology in resolving global sustainability challenges, and much more. A poster session will allow participants to present research, even if it is not focused on green chemistry or sustainable energy.

Information on the program is available online at www.acs.org/gcsummerschool

To apply for the Summer School, please submit the following materials to [email protected] no later than March 21, 2014:

 Completed application (the attached form is also available electronically at the url above). Our preferred file name format is to add your name to the current file name. (e.g. “app_form_smith_j.doc).

 Curriculum vitae (CV) or résumé which includes:

 Your name, mailing address, telephone number, and e-mail address  Name of your academic institution, department, and faculty advisor  Your academic degrees (earned and in progress) and relevant experience

 Letter of nomination from your university faculty advisor or an alternate faculty member

 Unofficial transcript of graduate courses

 One-page essay discussing your interest in green chemistry and sustainable energy. Please include information on relevant experience you have and how the Summer School would benefit you.

All materials must be received no later than March 21, 2014.

Applicants selected for the program will be notified on or before May 2, 2014.

You may reach us by:

E-mail: [email protected]

Standard mail: American Chemical Society Education Division Attention: Stephanie Wahl 1155 Sixteenth Street, NW Washington, DC 20036 USA

Fax: (202) 872-8068 APPLICATION

Materials must be received no later than March 21, 2014.

 Name

Last ______

First ______

Middle ______

Exactly as it appears on passport/ID ______

How it should appear on name badge ______

 Address

______

 Primary Telephone Number

______

 Primary E-Mail Address

______

 Gender A same-gender roommate will be assigned to each program participant

Male Female

 Would you like to present a poster of your research at the summer school?

Yes No

If you answered yes, what is the topic and/or title of your poster presentation?

______-Continued Next Page- -Application Continued-

 Can you be onsite for the entire program? July 15, 2014 (arriving by 4:00 PM) to July 22, 2014

Yes No

 Do you have any special dietary needs (vegetarian, low-fat, kosher, etc.)?

Yes No

If you answered yes, please list below:

______

 Do you require any other special accommodations?

Yes No

If you answered yes, please list below:

______

 Please provide an estimate (in US dollars) of your program-related expenses

Acceptance into the program is solely merit based. Expense estimation is used only for planning purposes. Any personal financial support you obtain will enable us to accept additional applicants.

Air fare (round trip coach) between your local airport and Denver International Airport (DEN)

______

Ground transportation (round trip) between your home or school and your local airport

______

Visa application fee, if applicable. We do not cover travel-related costs incurred in obtaining your visa.

______

Other (please specify)

______

Sub-total $______

- (minus)

Amount of support provided by your academic institution or faculty advisor

______

Total $______