PIPES Application Form

Note:Please see the Application Instructions for all required documentation. Incomplete applications will not be considered.

All sections and fields are required unless marked “(optional).”

Program Interest:

Check all that apply.



* Applications for the 2015 REU program are being accepted. Please note, we have submitted a renewal proposal to the National Science Foundation for our PIPES Research Experience for Undergraduates (REU) program. We anticipate a positive review response and are currently planning the 2015 program. Please check our website for updates regarding our 2015 REU program.

Personal and Contact Information:











Important note: This program relies heavily on email correspondence.

MM/DD/YYYY

Sex:

Citizenship and Residency:

Citizenship:

( )

Hawaiʻi Residency:

Born in Hawaiʻi:

Ethnicity and Race (optional):

This information is optional. Check all that apply.

( )


Please indicate all nationalities you identify with:




Does your Filipino heritage include Hispanic ancestry?


Please indicate nationality you identify with:


Please indicate all nationalities you identify with:



Academic Information:

Describe your current academic institution. Please note, you must be a continuing student to be eligible for the REU program (students graduating in the Spring will not be eligible for the summer REU program). REU applicants must be enrolled in an undergraduate program the semester following their summer internship.

Institution Size:



MM/DD/YYYY

Current Class Standing:




Program Dates:

Do you have any summer plans that would interfere with a 11-week internship starting the Tuesday after Memorial Day (in May)?


Research Interest:

Research areas of interest (check top 5):














Parental Education:

Please select the highest level of education completed.

Mother:




Father:




Medical Information:

Do you have any health conditions that may interfere with performing an internship requiring outdoor/physical activities (e.g., allergies or physical limitations)?

Do you have medical/health insurance?

2015 Education Awards Service Program:

Kupu’s Hawaiʻi Youth Conservation Corps’ Education Award Service (EAS) program is proudly partnering with the Pacific Internship Programs for Exploring Science (PIPES) program this summer.

 Through this partnership, you are eligible to receive $1,195 AmeriCorps education award for your participation in this year’s program. Eligible participants are required to complete 300 hours of service in the area of natural resource management before August 7, 2015. To be eligible:

  • Applicant must be a U.S. Citizen, U.S. National, or Legal Permanent Resident
  • Age 17 by May 26th, 2015

* Your participation in the Kupu EAS Program could affect the limit of terms you can serve as a volunteer in future AmeriCorps Educational Awards programs. Please contact Malia for more information.

For more information, please contact Malia Heimuli, (808) 735-1221 ext. 1023

Are you interested and eligible to participate in the KUPU Education Awards Service Program?

Verification of Honesty and Truth:

By typing my last name here, I certify that all of the statements and information provided in my application materials are true to the best of my knowledge.

Permission to Contact Instructors and Advisor:

By typing my last name here, I give the PIPES Office permission to contact my current or past instructors, advisors, and employers in regards to my performance in past/on-going related coursework/employment and my current academic standing within my institution.

Additional Documents

Don’t forget to submit the additional documents as requested on the application instructions page.