RUTGERS UNIVERSITY-NEWARK

							                     RUTGERS UNIVERSITY-NEWARK
                    COLLEGE OF ARTS AND SCIENCES
          DEPARTMENT OF EARTH AND ENVIRONMENTAL SCIENCES
                               AND
                        THE NEWARK MUSEUM




                         The GeoExplorers
                            Spring 2009

Please Print all information.



Last Name;___________________ First Name:_______________________

Home Address:_______________________________________________________

City:______________________ Zip Code:_________________________

Date of Birth:__________________ Gender:________________________

Ethnic Background:________________

Languages spoken besides English:_____________________________

Home Phone Number:____________________________

Emergency Contact name:______________________

Emergency Phone number:_____________________

Your email address:___________________________________


Your high school:_____________________________________


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Your present grade (please circle)    9     10    11     12

Name of your guidance counselor:____________________________

Math classes you have had:_______________________________________________

Science classes you have had __________________________________




In a typed essay, please explain why you would like to join the Geo
Explorers. Send this essay along with the fax

PLEASE FILL OUT APPLICATION AND EITHER FAX (973-353-5605 TO Jeanne) or
mail to:

Jeanne Giaimis
Coordinator, Institute For Pre-College Education and Community Outreach
Academic Foundations Center
Rutgers University-Newark
110 Warren Street
Bradley Hall, Room 109
Newark, NJ 07102

PLEASE GET APPLICATION TO ME NO LATER THAN:

DECEMBER 21, 2008




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