Application Part 1: Eligibility
The McNair Program is a funded by a TRIO grant from the U.S. Department of Education. Participants must meet academic and demographic criteria established by federal guidelines (see 34CFR647.3) Please use this form to complete an eligibility assessment. Applicants meeting the eligibility criteria will be notified within 1 week of their submission and asked to move to the second phase of the application process. Please contact Rhetta Seymour, Director, at 618-453-4585 or rseymour@siu.edu, if you have any questions.
Name
*
Last, First, M.
SIU ID#
*
Dawgtag (85x-xxx-xxx)
Email
*
example@siu.edu
Cell Phone
*
Gender
*
Please Select
Male
Female
Prefer not to respond
Date of Birth
*
-
Month
-
Day
Year
Date
Enrollment Date at SIU
*
-
Month
-
Day
Year
Date
Graduation Date
*
-
Month
-
Day
Year
Date
Are you a transfer student?
*
Please Select
NO
YES
If yes, please list name of the institution.
Major
*
Cumulative Grade Point Average
*
Overall GPA
Class Standing
*
Please Select
Freshman (0-26)
Sophomore (27-56)
Junior (57-86)
Graduating Senior (87+)
Senior-Continuing (87+)
How many Credit hours are you enrolled in this semester?
*
Indicate if you have participated in any of these TRIO Programs:
*
Educational Opportunity Center
Talent Search
Student Support Services
Upward Bound
None of the above
Indicate if you are affiliated with any of these University centers/offices.
*
SI Bridges
First Saluki Center
University Honors
REACH
SMC Resource Center
Bryson Future Scholars
Saluki Success
None of the Above
Other
Date you enrolled in any college or university.
*
MM-YYYY
Research Experience
Do you have any current or prior research experience?
*
No
Yes
If yes. please describe your current or prior research experience.
i.e. Lab assistant in Dr. Maroon's Chemistry lab
Interest in Graduate Education
What is the name of the graduate program or department you are interested in?
What semester do you plan to enroll in graduate school?
MM-YYYY
Which statement best describes your current commitment to enrolling in graduate school?
*
I am thinking about graduate school and would like help exploring my options.
I plan to go to graduate school but not immediately after graduation.
I will go to graduate school immediately after graduation.
Which statement reflects the type of degree you would like to pursue after earning your bachelors degree?
*
I plan to pursue a PhD.
I plan to pursue a Master's degree, but I am not certain about a Ph.D.
I plan to pursue a Medical Degree.
I plan to pursue a Law Degree.
Other
Needs Assessment
Please check the services and programming assistance that you believe you need most in order to be successful in graduate school.
*
Preparation for the Graduate Record Exam (GRE).
Information about the graduate school application process.
Assistance preparing a personal statement and applications for graduate school.
Travel support for conferences or graduate school visits.
Information about financial aid and paying for graduate school.
Help choosing graduate school programs or institutions.
Improvement in time management and organizational skills.
Undergraduate Research Experiences
Assistance with professional development including etiquette, public speaking and interviewing.
Faculty and peer mentoring.
Tutoring.
Exposure to cultural events and academic programs not usually available to me.
Academic counseling.
Eligibility Criteria
Which statement best describes your citizenship status?
*
I'm a citizen or national of the U.S.
I'm a permanent resident of the U.S.
I'm in the U.S. for other than a temporary purpose and can provide evidence from the Immigration and Naturalization Service of my intent to become a permanent resident;
I'm a permanent resident of Guam, the Northern Mariana Islands, or the Trust Territory of the Pacific Islands;
I'm a resident of one of the Freely Associated States.
None of the Above
Are you Hispanic or Latinx?
No
Yes
Race/Ethnicity
American Indian
Black or African American
Native Alaskan
Hawaiian or Pacific Islander
White or Caucasian
Other
What is your father's highest educational degree?
*
Please Select
Less than High School
High School diploma
Associate's Degree
Bachelor's Degree
Master's Degree
Doctorate
Law Degree
Medical Degree
Unknown
What is your mother's highest educational degree?
*
Please Select
Less than High School
High School diploma
Associate's Degree
Bachelor's Degree
Master's Degree
Doctorate
Law Degree
Medical Degree
Unknown
Which parent did you regularly reside with and receive support from prior to the age of 18?
*
Please Select
Mother (natural or adoptive0
Father (natural or adoptive)
Both Mother and Father
Neither Mother nor Father
Income
Based on what you reported on your most recent FAFSA, indicate the number of people in your household. Also, you will need your family's most recent federal tax return to report the taxable income. Note, taxable income is the adjusted gross income minus exemptions as reported on tax return. Be sure to use your parent/guardians tax return if are still claimed on their tax return. Only use your personal tax return if the SIU Financial aid office considers you an independent student. Contact McNair staff at rseymour@siu.edu if you have any questions about this criteria.
Do you currently receive Pell grant funding?
*
No
Yes
Do you currently receive MAP grant funding?
*
No
Yes
Number of people in household
*
Taxable Income
*
Line 15 on Form 1040 (Do not list adjusted gross income)
Please use this section to list any special circumstances you feel may be relevant to your application.
Signature
I certify that the above information is true, and I hereby authorize the SIU McNair Program to obtain educational and financial records and information as deemed appropriate by the program staff. The information requested in this form is used to determine eligibility and to provide program demographics on the annual performance report required by the U.S. Department of Education. All information will be kept confidential by the program staff.
Submit
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