McNair Program Application

McNair Program is required to verify that our participants meet Federal criteria regarding educational background and household income and ensures that all information will remain confidential.

Please enter the amount which reflects the taxable income reported on your income tax return. You may estimate your household income using your pay stubs or W2s. TRIO Eligibility Effec.1/12/22

This release form enables the RIC McNair Scholars Program to obtain the following information for the purpose of determining eligibility, developing education plans, and collecting program statistics:

• College/university admission & enrollment
• Grade reports/transcripts
• Financial aid reports and information regarding scholarships, fellowships, and other awards received
• U.S. residency status
• Current contact information (address, phone number, email address)
• Past TRIO participation

Aspects of this information and the nature of your participation in the McNair Scholars Program may be shared with the U.S. Department of Education, the McNair Program Advisory Committee and RIC personnel in accordance with federal regulations and RIC policy.

My signature below indicates that I hereby authorize the release of my academic, personal, and medical (when necessary) records to the McNair Program at Rhode Island College for the purpose of serving my needs and meeting its federal regulations. I also hereby attest that, to the best of my knowledge, the information given in this application is true, complete, and accurate.

Please read and sign the following statement:

The Ronald E. McNair Scholars Program is a federally funded project designed to increase the number of underrepresented individuals pursing doctoral study. The information on this form is required and is strictly confidential; it will only be used to determine eligibility. Please verify that you have the eligibility requirements below.

I hereby certify that all of the above information is true and correct to the best of my knowledge. I further authorize the Rhode Island College Ronald E. McNair Scholars Program to accessand review my academic transcripts for the purposes of verifying my eligibility and aiding inmy potential selection for program.

Please check all of the services on the list provided below that you feel you need most in your pursuit of a doctorate degree:

Photo, Video and Information Release Agreement

I {main_name} grant the Rhode Island College, Ronald E. McNair Scholars Program the right to use my name and picture, without compensation to me, in electronic media (i.e. websites and emails) and written materials (i.e. advertising material and brochures) for promotional fund raising and educational purposes.

I understand that the Rhode Island College Ronald E. McNair Scholars Program will use my information for promotional and educational purposes. I hereby agree to hold the University of California, Berkeley Ronald E. McNair Scholars Program, its staff, and its affiliates harmless from any liability resulting from the use of the information, text, and pictures herein submitted.

PERSONAL STATEMENT

Please attach your personal statement to this application, it should be no more than 500 words, typed (12 pt. font) and double – spaced. Please be sure to write a strong, clear, and concise statement of purpose addressing the questions below

Please write a statement describing your educational and career goals from completion of yourundergraduate degree through completion of your graduate/doctorate-level degree. Explain what you have done to prepare yourself to meet these goals (courses, work, extracurricular activities, etc.). Inwhat ways would you like the McNair Program to help strengthen your preparedness for graduate school? What motivates you to pursue graduate studies? In addition, outline one or more research interests upon which you would like to focus during the McNair summer research fellowship.