Undergraduate Research Interest Form

Your Name:

First NameLast Name

NSHE ID (Student ID Number):

Email:

example@mail.tmcc.edu

Phone Number:

Please enter a valid phone number.Format: 000-000-0000.

Have you participated in undergraduate research at TMCC before?

I would like to participate in research during the following term(s):

Which project(s) or mentor(s) would you like to work with?

List up to three projects/mentors.

Describe your interest in participating in research and how it might relate to your long-term goals:

Provide 1-2 professional references:

For each reference, please list the reference's full name, email and/or phone number, and how they know you. These references should come from people who can speak to your work ethic and reliability (e.g., a supervisor, instructor, etc.)

How would you like to work on this project?

How many credits are you currently enrolled in at TMCC?

Are you over the age of 18 at the time of completing this survey?

What is your US citizenship status?

Are you currently working for TMCC or any other Nevada System of Higher Education (NSHE) institution?

Have you ever worked for TMCC or any other Nevada System of Higher Education (NSHE) institution?

Please list your other NSHE jobs:

Include your job, NSHE campus (TMCC, UNR, etc.), and the number of hours per week you work for each job listed.

What is your planned major?

Do you have anything else you would like to share or any additional questions regarding this opportunity?

Please verify that you are human:

Sender Name: