Fired Up Application 2010

							                                     Fired-Up About Research,
                                            Science and
                                   Engineering Summer Academy
  The "Fire-up about Research, Science and Engineering" summer academy is designed for Oklahoma high school students who have
                         completed their freshman, sophomore or junior year in the Spring of 2010. The program will introduce
                         several aspects within the fields of Science Engineering through the use of academic projects that are
                         designed to stimulate creativity, and be fun! The academy is funded by the Oklahoma State Regents for
                         Higher Education (OSRHE) and OSU, so there is NO CHARGE to participants. All project supplies and
                         equipment, instruction by OSU faculty, lunches, and transportation to scheduled activities during the
academy will be provided. Assistance for transportation to and from the campus may be provided, based on need. The academy takes
place July 11-16, 2010 and includes meals and any dormitory facilities. For more information contact, Jovette Dew (405) 744-2920, or
via email at jovette.dew@okstate.edu.
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Name (Last)                                                   (First)

Home Address                                                                          Phone: (           )

City                            County                   State                  Zip              Email                  @

Date of Birth                    High School

Date of High School Graduation                  G.P.A.             Class Size          Rank           if available

ACT Scores (if Available) English           Math          Reading           Science           Composite

Has someone from your household graduated from college: (place an X by yes or no) Yes            No

List your activities, leadership responsibilities, and honors. Please print or type in black ink, and use only the space provided.
Extra-Curricular or Civic/Community Activities (include any clubs, organizations, volunteer groups and work):



Honors or Awards:

Favorite Classes: (place an X by those that apply)
Math                   English                  Music                       Spanish                            Biology
Chemistry              Physics                  Literature                  Government                         Economics
History                French                   German                      Pre-Engineering                    Machining
Auto                   Career Tech              Geography                   Physical Education                 Other

Recommendation: Give the name of a teacher or counselor who w i l l recommend you (omit i f home schooled)
Name:                          email or phone #:                            School:

Other OSRHE Academies attended;

Other OSRHE Academies applied for in 2010:

Application deadline is April 15, 2010. Notification of acceptance into the program will occur by May 15', 2009. I hereby authorize
the release of information contained in this application to authorized campus personnel.

S i g n e d : __________________________________________________ D a t e :                            , 2010
Mailing instructions on the back



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Several hundred Oklahoma students are applying for State
Regents Summer Academies. Students attending more than one
State Regents Summer Academy may prevent many other
students from having this opportunity. Although some Academies
do not have waiting lists, others have very long waiting lists.

So that more students may attend a State Regents Summer
Academy, I will notify Academy Directors if I am accepted for
more than one 2010 Academy.

Applicant Signature ______________________________________


Instructions: Please complete the application, sign and mail or FAX the application to:

Fired-Up About Research Science and Engineering
Diversity Academic Support/ Jovette Dew
109 Thatcher Hall
Stillwater, OK 74078
FAX number: 405.744.4202

The applications must be postmarked by April 15, 2010 and received prior to April 22, 2010.
Selected applicants will be notified by May 15, 2010.




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