Application Form Research Experiences for Undergraduates in Distributed Rational Agents Summer 2003 A. Personal Information: 1. Name: ______________________________ 2. Social Security No.: _______________________ 3. Date of Birth: ________________________ 4. U.S. Citizen/Permanent Resident: Yes No 5. Home Address: _______________________________________________________________________________ _______________________________________________________________________________ 6. School Name and Address (include E-mail, if any): _______________________________________________________________________________ _______________________________________________________________________________ 7. Telephone numbers: Home: ______________________ School: _________________________ 8. Names of Refereneces: _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ B. Academic Background: 1. Current cumulative GPA: _______________ 2. Major: ________________________________________ 3. Number of credit hours completed: _______ 4. Classification in Fall 2003 semester: Sophomore Junior Senior 5. Academic and Extra-Curricular Accomplishments (including awards, prizes, scholarships): ____________________________________________________________________________________________ ____________________________________________________________________________________________ 6. Briefly explain any team work or group project you have been involved with: ____________________________________________________________________________________________ ____________________________________________________________________________________________ 7. Computer Systems, Programming Languages, and Operating Systems Experience: ____________________________________________________________________________________________ ____________________________________________________________________________________________ C. General: 1. Career Goals: ____________________________________________________________________________ ____________________________________________________________________________________________ 2. Memberships in clubs, groups, and societies: ____________________________________________________________________________________________ 3. Please indicate any additional information which you consider to be helpful for your application: ____________________________________________________________________________________________ ____________________________________________________________________________________________