Ka`imi`ike Program Internship Application Form

Ka`imi`ike Program School of Oceanography and Earth Science and Technology University of Hawai‘i at Manoa Internship Application Form Priority Due Date: May 1st Annually (A) PERSONAL AND CONTACT INFORMATION Full Name: ______________________________________________________________ Last First Middle Gender (circle one): M or F Current Mailing Address: _____________________________ _____________________________ _____________________________ Phone: (Home) ________________________ (Cell/Pager) _____________________ Permanent Mailing Address: _____________________________ _____________________________ _____________________________ Email:__________________________ IMPORTANT NOTE: We rely on email for most correspondence. Other _________ CITIZENSHIP: US ______ U.S. Permanent Resident ______ ETHNIC ORIGIN: (check all that apply) __ African-American __ American Samoan __ Asian __ Caucasian __ Filipino __ Hispanic __ Melanesian __ Micronesian __ Native American __ Native Hawaiian __ Other (Please specify) ________________ (B) ACADEMIC INFORMATION Current class standing: ___Freshman ___Sophomore ___Junior ___Senior Cumulative GPA: _________ GPA Last Semester: _________ Major:__________________ Minor or certificate (if any): _________________ Expected graduation with Bachelor Degree: ___ Fall ___Spring ___Summer Year: 20___ 01/09 Ka`Imi`Ike Internship Application Page 1 (C) TRANSCRIPT(S) Submit a copy of your current transcript(s) with your application. We accept UNOFFICIAL TRANSCRIPTS. Please note the following:  For TRANSFER students, please also submit transcripts from your previous institution(s) (E) RESUME Attach your current resume to the application packet, and be sure to include the following information (please do not limit yourselves to one page):     Work, volunteer or research experience Computer or Laboratory Skills Awards, honors and scholarships Related hobbies (i.e., free diving, hiking, etc.) (F) ACADEMIC REFERENCE and MENTOR Please provide a letter of reference from a person whom is knowledgeable about your academic studies. This person should be a professor or teacher, or have good knowledge of your academic and career potential. If you have not yet selected a mentor you would like to work with, leave the line below blank and we will help you find one based on your interests. Mentor’s Name ________________________________ Dept, Institution, or Company ______________________ Email ____________________ Phone Number _______________ (G) PERSONAL STATEMENT On a separate sheet of paper please answer the following question, and limit your response to 300 words or less. “Describe your interest in ocean and earth science-related fields, as well as the career-related activities that you would like to be doing after graduation.” (H) APPLICANT’S CERTIFICATION By signing below, you certify that the responses provided above are complete and true to the best of your knowledge and belief, and that you are a U.S. Citizen or Permanent Resident. _________________________________________ Signature Mail Application to: Barbara Gibson Univ. of Hawaii at Manoa 2525 Correa Rd. RM 215 Honolulu, HI 96822 _____________________ Date Or Hand Deliver to: UH Manoa, HIG 215 Or FAX: 808.956.5524 Questions? Call 808.956.0403 or email bgibson@hawaii.edu 01/09 Ka`Imi`Ike Internship Application Page 2

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