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RESEARCH SCIENCE INSTITUTE

2011 APPLICATION

The application is designed to show the applicant's background in academics, leadership, and service, as well as personal
achievements and goals indicative of becoming a leader in science, technology, engineering, or mathematics.

The application has five parts. Part I must be completed by the applicant. Part II must be completed by the applicant and
should be reviewed by his/her teachers to ensure accuracy and completeness of information. Part III must be completed
by the applicant's math or science teachers or research supervisor. Part IV is a certified copy of the applicant's high school
record that includes a transcript of courses, grades, and standardized test scores. Part V is completed by the applicant and
a parent/guardian. The applicant and two teachers must be sure that all the information requested is given accurately and
completely before mailing. Please do not send supplementary materials that are not requested. The complete set of
application materials must be mailed to the Center for Excellence in Education in an envelope large enough to
accommodate an original unfolded application. Please do not staple or fold the pages of the application. Applicants must
follow the instructions to ensure the completion of each part of the application. Applicants who do not conform to the
requirements will not be considered.

Each application must include:

Part I: Complete applicant and high school information form

Part II: Completed answers to questions on self-nomination form with essay responses to the questions detailing his or her goals in
science and/or mathematics.

Part III: Two teacher recommendations in sealed envelopes. The teachers should be familiar with the applicant and the applicant's
scholastic record. Applicants who have participated in a research project of 4 weeks or longer at a university or a laboratory
should request a recommendation from the research supervisor.

Part IV: The applicant's official high school transcript and standardized test scores, such as the *PSAT math, verbal and writing
scores (or SAT or ACT test results) showing evidence of exceptional intellectual performance and potential.

Part V: Completed release information signed by the applicant and parent/guardian.

$50.00 application fee - checks should be made payable to CEE. (please be sure to check box if requesting to waive fee)
Stamped, self-addressed postcard for verification of application receipt (optional).

*PSAT math scores should be at least 76, and combined math, verbal, and writing PSAT scores should be at least 220.
ACT minimum math scores should be 33 and reading, 34. Lower scores must be offset by strong indications of mathematical,
scientific, and academic potential exemplified in recommendations, high school grades, and science activities.

Center for Excellence in Education

8201 Greensboro Drive, Suite 215
McLean, VA 22102

Dates to Remember
January 14, 2011: Application deadline for receipt at the CEE office. This is NOT the postmarked date.
Last week in March: Students notified of selection by mail.
June 19 to July 30, 2011: RSI summer program at MIT
 RESEARCH SCIENCE INSTITUTE 2011
APPLICATION: PART I
APPLICANT AND SCHOOL INFORMATION
To be completed by applicant. Print & mail completed application to CEE.
Please type or clearly print answers. Deadline for receipt: January 14, 2011

APPLICANT INFORMATION

Indicate Female
Gender
Male
Last Name First Name Middle Initial

Street Address City State Zip

Country of Citizenship (if not US Citizen) Immigration Status Home Phone Number Cell Phone Number

Email Address

Birthdate (M/D/Y) Grade Enrolled (Fall 2010) College Start Date (M/Y)

HIGH SCHOOL INFORMATION HIGH SCHOOL PRINCIPAL INFORMATION

High School Name Principal's Prefix (Mr./Mrs./Ms./Miss)

School Address 1 Principal's First Name Last Name

School Address 2 Principal's Professional/Adminstrative Title

City State Zip

Country School Phone Number Principal's Email Address

School Email Address School Website Address

Mail RSI application to:

Center for Excellence in Education

8201 Greensboro Drive
Suite 215
McLean, VA 22102

For futher information email: rsi@cee.org

 RSI 2011 APPLICATION: PART II
APPLICANT QUESTIONS & SELF-NOMINATION
To be completed by applicant. Print & mail completed application to CEE.
Please type or clearly print answers. Deadline for receipt: January 14, 2011

1. Please complete the following charts indicating course work through the end of the 2010-2011 school year.

COURSE LEVEL

Subjects Regular Honors College Date Completed/Expected

Calculus AB BC
Multivariable Calculus

Linear Algebra

Statistics

Biology

Chemistry

Computer Science A

Environmental Science

Physics B C

Other:

Other:

SKILL LEVEL

Computer Platform Beginning Intermediate Advanced

C/C ++
Java
Perl/Python
MATLAB
Mathematica/Maple
Unix/Linux
LaTeX

Other:

Other:
 RSI 2011 APPLICATION: PART II
APPLICANT QUESTIONS & SELF-NOMINATION
To be completed by applicant. Print & mail completed application to CEE.
Please type or clearly print answers. Deadline for receipt: January 14, 2011

Test (If taken) Test Score Test Date Test (If taken) Subject Test Score Test Date
PSAT Math SAT I Math

PSAT Verbal SAT I Verbal

PSAT Writing SAT I Writing

SAT II
ACT English

ACT Math SAT II

ACT Reading SAT II

ACT Science ACT Science

Please include an unofficial score report with your application and have your school send certified test scores with your
transcript.

2. Indicate your first and second Research Field Choice: these must be two distinct fields. Within each field, select a Subfield.
An example would be: Research Field Choice: Biology Subfield:.Neurology

Research Field Choice I: Subfield:

Research Field Choice II: Subfield:

Please respond to Questions 3 to 8 on separate paper, not to exceed a total of three single spaced typewritten pages. Provide specific
details that give strong evidence of your promise in the sciences and mathematics. Should you be accepted, this information will be
used to place you with a research mentor. Limit your responses to 1 to 2 paragraphs per question.

3. In each Research Field selected in Question 2, please state what you perceive as the one or two most interesting questions/
problems in this field. Explain why they interest you.

4. What are your long-range goals?

5. What extracurricular activities and/or hobbies demonstrate your interest and ability to undertake scientific or mathematical
research? (Give some measure to the extent of your participation and/or accomplishments in math or science competitions,
research internships, and awards received.)

6. Describe your involvement and participation in extracurricular and community activities that do not relate directly to
science, technology, engineeering, or mathematics.

7. Briefly describe any past experience with computer programming, modeling, and data analysis.

8. How did you hear about RSI?

 RSI 2011 APPLICATION: PART III
TEACHER RECOMMENDATION

To be completed by two of the applicant's science or math teachers Print & mail completed application to CEE.
or research supervisor. Please type or clearly print answers. Deadline for receipt: January 14, 2011

Student's Name
Please return this recommendation to the student named above in a sealed envelope. Feel free to use additional space or provide a
letter on your school stationary if preferable.

1. Summarize the reasons you believe this student has the potential to become a leader in science or math. (1000 Characters)

2. What do you consider this student's principle intellectual and personal strengths and weaknesses which should be considered in
evaluating his/her candidacy for RSI? In particular, please give specific examples of how this student has pursued independent
learning. (1000 characters)

Teacher Name Subject(s) Taught Signature

Name of School School Phone Number Teachers Email Address Date

 RSI 2011 APPLICATION: PART IV
Academic Documentation
Reminder, be sure to include the following:
To be completed by applicant. Print & mail completed application to CEE.
Please type or clearly print answers. Deadline for receipt: January 14, 2011
Reminder: Be sure to include the following
• Unofficial High School Transcript (School should send certified transcript and test scores)
• PSAT math, verbal and writing scores or SAT or ACT test results showing evidence of exceptional intellectual performance
and potential.

RSI 2011 APPLICATION: PART V

APPLICANT AND PARENT/GUARDIAN RELEASES
To be completed by applicant and parent/guardian. Print & mail completed application to CEE.
Please type or clearly print answers. Deadline for receipt: January 14, 2011

APPLICANT
I, , hereby grant permission for my name to be placed in candidacy
for selection as a RSI Scholar. I request that all school data in support of my nomination be at the disposal of the Center for
Excellence in Education.

Applicant's Signature
PARENT/GUARDIAN Date
If my child is selected for RSI, I will urge him or her to participate in CEE activities through undergraduate and graduate years
of study. I know our support is essential. I will financially support and consider volunteering for CEE on our child's behalf.

Parent/Guardian Prefix Parent/Guardian First Name Parent/Guardian Last Name

Parent/Guardian Daytime Phone Number Parent/Guardian Home Phone Number Parent/Guardian E-mail Address
Parent/Guardian Signature
FOR YOUR APPLICATION TO BE CONSIDERED, PLEASE MAKE SURE THAT YOU HAVE INCLUDED THE
FOLLOWING:

Part I: Completion of Applicant and High School information

Part II: Completion of answers to questions
Part III: Completion of two recommendations by Teachers and/or Laboratory Supervisor, in sealed envelopes
Part IV: A unofficial high school transcript and standardized tests scores report. School should send certified trascript and test scores.
Part V: Completed and signed applicant and parent/guardian release
Application Processing Fee of $50 (Please make checks payable to CEE) Enclosed Please waive the fee
Self-addressed stamped postcard for application receipt verification (optional) Not enclosed
Enclosed

All parts of the student application should be enclosed in one envelope. Partial applications or applications received after
January 14, 2011 (January 14, 2011 postmark is NOT acceptable) will be considered incomplete and will not be considered.