University Of Colorado-Boulder-McN-2023 Application Form

McNair Scholars Program Application

Applications are submitted until the posted deadline on our website at colorado.edu/mcnair. Only students pursuing a graduate program leading to a PhD/EdD are eligible to apply.

I. Applicant Information
Name*

First NameMiddle NameLast Name
Local Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Permanent Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Main Phone
(999)999-9999
Alternative Phone
(999)999-9999
CU Email Address *
example@example.com
Alternative Email Address
example@example.com
Student ID
Date of Birth

MonthDayYear
Date
Gender Expression/Identity
Personal Pronouns
Provide a contact of someone who will know how to reach you post-graduation (i.e.,
parent, guardian, relative).
Provide a contact of someone who will know how to reach you post-graduation (i.e., parent, guardian, relative).

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone
(999)999-9999
Email
example@example.com

Financial Information

	Yes	No
1. I was born before January 1, 2000
2. I am married.
3. I have children or dependents who received more than 50% of their support from me.
4. The university classifies me as an independent.
5. I was an orphan or ward of the court or in foster care after age 13.
6. I am an emancipated minor or in legal guardianship.
7. I am an unaccompanied minor who was homeless or self-supporting.
8. I am a veteran of the United States Armed Forces.

If you answered no to all questions, you are classified as dependent. Answer the
following questions.

Dependent Financial Information
1. What is the size of your family unit, including yourself?
2. What was your parents' 2022 or 2023 Taxable Income* (not Adjusted Gross Income)?
3. Who's name(s) are on the tax forms reporting the taxable income above?

First NameLast Name
4. What was your 2022 or 2023 Taxable Income* (not Adjusted Gross Income)?
5. If parent did not file income tax return, what was household income for 2022 or 2023?
*Taxable Income Information - IRS Form 1040 line 43; IRS Form 1040A line 27; IRS Form 1040EZ line 6

Independent Financial Information
If you answered yes to any questions, you are classified as independent. Answer the following questions.
1. What is the size of your family unit, including yourself?
(Example: you, mom, sister = 3)
2. What was your 2022 or 2023 Taxable Income* (not Adjusted Gross Income)?
*Taxable Income Information - IRS Form 1040 line 43; IRS Form 1040A line 27; IRS Form 1040EZ line 6
If you are selected for an interview, you or your parent(s)/guardian(s) will be asked to complete and sign a financial certification form. This form must be submitted to us before you can be admitted to the program. This information will be treated confidentially.
First-Generation College Student from Low-Income Background
httQs://www2.ed.gov/about/offices/list/oQe/trio/incomelevels.html

IV. UNDERGRADUATE RESEARCH EXPERIENCE
Have you been involved in an undergraduate research experience in the past? (If yes, please describe the project and provide the name of your faculty mentor below.)
Do you have plans to conduct an undergraduate research experience in the future? (If yes, please describe the project and provide the name of your faculty mentor below.)

V. Important Documents
Provide a personal statement addressing your professional goals for the future,
including the following information:
• how a doctoral degree fits with your current career plans;
• what you hope to gain from participating in the McNair Scholars Program;
• how your background prepared you for the rigors of our program and doctoral
study;
• what possible topics/research interests you may want to explore in a McNair
research project.
Please use 12-point font, double spaced, and a maximum of two (2)
pages.
Upload Statement Here

Cancelof
Please submit your Unofficial Transcripts to this dropbox. You may access your free unofficial transcript via https://buffportal.colorado.edu/. If you attended other institutions in addition to CU Boulder, please also submit those unofficial transcripts.

Cancelof
Extra Document Upload

Cancelof

VI. RECOMMENDATIONS
Provide contact information for recommenders who can attest to your academic
ability, potential for conducting research in your discipline, and motivation/preparation to undertake graduate study. At least one of the recommenders should be a faculty member at CU Boulder.
Recommender Name 1

First NameLast Name
Recommender 1 Title & Department
Recommender 1 Email Address
example@example.com
Recommender Name 2

First NameLast Name
Recommender 2 Title & Department
Recommender 2 Email Address
example@example.com
I certify that the above information provided in this form is true and accurate to the best of my knowledge.
Signature

Clear

McNair Scholars Program Application