Center for the Integrative Study of Animal Behavior

1. Name
   First: Middle Initial: Last:
2. Date of Birth: (mm/dd/yyyy)
3. Gender: Male Female
4. Citizenship (Applicants must be U.S. Citizens or Permenant Residents):
   U.S. Citizen U.S. Permanent Resident
5. Email:
6. Current Address:
   Street Address:
   City: State: ZIP:
   Phone: Cell Phone:
7. Full Permanent (Parent's) Address:
   Street Address:
   City: State: ZIP:
   Phone:
8. Optional: One important goal of the Turner Program is to encourage participation of individuals from groups underrepresented in science. Please check ALL categories that apply to you.
   
   First generation college
   Low income
   African (Black) American
   Asian American
   Mexican American (Chicano)
   Native American. Tribal Affiliation:
   Puerto Rican
   Other Hispanic
   White, non-Hispanic
   Other. Specify:
   Disability. Specify:
9. Current Studies
   Current Institution:
   Primary Field of Interest:
   Overall GPA:
   Major:
   Current GPA in Major:
   Academic Advisor's name:
   Year in School: Freshman Sophomore Junior Senior
10. References:
    Please have one individual familiar with your academic or research work email a letter of recommendation to Peggy Hill at peggy-hill@utulsa.edu. Enter their name and contact information below.
    
    Name:
    Relationship to Applicant:
    Phone:
    Email:
11. Future Plans:
    When do you expect to receive your Bachelor's Degree? (mm/yyyy)
    Students who will have completed all requirements for the bachelor's degree before January 2013 are NOT eligible for the Turner program.
    
    After graduation, do you plan to continue work towards: graduate degree (M.S. or Ph.D.) in science health-related degree (M.D., nursing, etc.) veterinary degree employment
    Please give further details on your choice:
12. How did you hear about us? Newsletter or Mailing Conference Exhibit Advisor or Friend Animal Behavior Society Web site CISAB Web site Other internet site
13. Research Abstract:
    If you plan to present your research as a poster or talk at the Animal Behavior Society meetings, please submit an abstract through the conference website and then enter a copy of your abstract below. Research presentation is not required for participation in the Turner program.
    
14. Personal Goals:
    Briefly explain what you hope to gain from participating in the Animal Behavior Society meetings and how this will help you attain your academic/career goals.
    

Once the form has been completed, please click below to submit your application. If you do not receive an email confirming receipt of your application, please contact CISAB at cisab@indiana.edu. Don't forget to ask your reference to send his or her letter of recommendation to peggy-hill@utulsa.edu.