Research Experience for Teachers
2004 Summer Application

Materials Research Science and Engineering Center
Nanoscale Science and Engineering Center

Harvard University

Applicant Information

Address (school):

City: ST: AK AL AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MA MD MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY PR AS ZIP:

Phone: Email:

Address (home):

City: ST: AK AL AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MA MD MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY PR AS ZIP:

Phone: Email:

Courses:

Please list the courses you teach, as well as the number of students in each class.

What attracted you to this program?

Other relevant experience :

Please list research, education, or other information you would like us to consider.

Name at least one reference :

Please include the name, address, telephone number and email address (if available) of at least one reference.

Kathryn Hollar
Director of Educational Programs
Harvard University
Pierce Hall Room 206A
29 Oxford St.
Cambridge, MA 02138

Application Deadline: Friday, April 9, 2004.