University Research Scholar Nomination

1. Applicant Information

First Name: Last Name:


Address:  City/State     ZIP:

Department/Program:

Expected Date of Graduation: mm/dd/yy

Phone: Email:

Student ID Number:


2. Faculty Research Advisor Information

First Name:   Last Name:

Department/Program:

Phone/Email:

3.    UNCA Symposium Presentation  Fall or Spring
                       Date:    Month/Year

                       Title:
   

4.    Publication in one of the following: Check all that apply
            Proceedings of the National Conference on Undergraduate Research (NCUR).
            Proceedings of the Big South Undergraduate Research Symposium (BigSURS)
            State of North Carolina of Undergraduate Research Symposium (SNCURS)
            Appropriate Disciplinary Conference Proceeding:
            UNC Asheville Journal for Undergraduate Research:

            Appropriate Disciplinary Journal:    Reference:

            Other Refereed Literary Medium:    Reference: 

            Other possibility, not covered by above criteria, e.g., art show, theatrical or
                musical performance, video etc. (must attach detailed description).

            Submission of a written paper to the Undergraduate Research Program Advisory
                Council for evaluation and recommendation (attach copy of paper to this
                form).

      Title  of Conference/Journal/ Referred Literary Medium.   Date:     Month/Year