The application is designed to show the applicant's background in academics, leadership, and service, as well as personalachievements 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 becompleted by the applicant's math or science teachers. Part IV is a certified copy of the applicant's high school record thatincludes 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 andcompletely before mailing.

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 notconform to the requirements will not be considered.

Each application must include:• Part I: Completed 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• 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 andpotential

• Part V: Completed release information signed by the applicant and parent/guardian• $50 Application Fee: Checks should be made payable to CEE• Stamped, self-addressed postcard for verification of application receipt (optional)

*PSAT math scores should be at least 75, 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.

RESEARCH SCIENCE INSTITUTE 2010US CITIZEN/PERMANENT RESIDENT APPLICATION

Dates to RememberJanuary 15, 2010: Application deadline for receipt at the CEE office. This is not the postmarked date.March 26, 2010: Students notified of selection by mail.June 20 to July 31, 2010: RSI summer program at MIT

Mail the RSI application to:

Center for Excellence in Education8201 Greensboro Drive, Suite 215McLean, VA 22102

To be completed by the applicantDeadline: January 15, 2010

Complete electronically and print off on printer, where possible.If necessary, please hand print very clearly.

First Name Middle Initial

City State

Email Address

Country of Citizenship

FemaleMale

(if not US Citizen) Immigration Status

APPLICANT INFORMATION

Last Name

Street Address Zip

Home Phone Number

Grade Enrolled (Fall 2009) College Start Date (M/Y)Birthdate (M/D/Y)

RESEARCH SCIENCE INSTITUTE 2010

The RSI application should be mailed to:Center for Excellence in Education

8201 Greensboro DriveSuite 215

McLean, VA 22102For further information email: rsi@cee.org

APPLICATION: PART IAPPLICANT AND SCHOOL INFORMATION

Indicate Gender(optional)

HIGH SCHOOL INFORMATION

School Address 1

State Zip

School Phone Number

High School Name

City

Principal's Title (Mr./Mrs./Ms./Miss)

School Email Address

School Address 2

Country

Principal's Professional/Adminstrative Title

HIGH SCHOOL PRINCIPAL INFORMATION

Principal's First Name Last Name

Principal's Email Address

Date/Time Field

RSI 2010 APPLICATION: PART IIAPPLICANT QUESTIONS & SELF-NOMINATION

To be completed by the applicantDeadline: January 15, 2010

1. Please complete the following charts:

C/C++JavaPerlMATLABMathematica/MapleUnix/LinuxLaTeXOther

Please respond to Questions 3 to 7 on separate paper not to exceed a total of three typewritten pages. Provide specificdetails that are strong evidence of your promise in the sciences and mathematics. Should you be accepted, this informationwill 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 math- ematicalresearch? (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 toscience, technology, engineeering, or mathematics.7. Briefly describe any past experience with computer programming, modeling, and data analysis.

2. Indicate your first and second Research Field Choice. Within each field, select a Subfield. An example would beResearch Field Choice: Biology Subfield:. Neurology

Research Field Choice I: Subfield:

Research Field Choice II: Subfield:

Complete electronically and print off on printer, where possible. If necessary, please hand print very clearly.

SAT I MathSAT I ReadingSAT I WritingSAT IISAT IISAT IISAT II

PSAT MathPSAT VerbalPSAT WritingACT EnglishACT MathACT ReadingACT Science

Test (If taken) Test Score Test Date Test (If taken) Subject Test Score Test Date

PSAT/SAT/ACT SCORES (OFFICAL COPIES OF SCORES REQUIRED )

Calculus: AB BC

Linear AlgebraStatisticsBiologyChemistryComputer Science A AB

Environmental SciencePhysics: B C

Other

DateCompleted/Expected

CollegeAP/IB

HonorsRegularSubjects

COURSE LEVEL SKILL LEVEL

ComputerPlatform

/ExpectedCompleted

DateBeginning IntermediateAdvanced

Teacher Name

High School

Subject(s) Taught

School Phone Number

Signature

Date

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 shouldbe considered in evaluating his/her candidacy for RSI? In particular, please give specific examples of how this student haspursued independent learning. (1000 characters)

Please return this recommendation to the student named above in a sealed envelope. Feel free to use additionalspace or provide a letter on your school stationery if preferable.

Student's Name

Complete electronically and print off on printer, where possible. If necessary, please hand print very clearly. To be completed by two of the applicant'sscience or math teachers

Deadline: January 15, 2010

RSI 2010 APPLICATION : PART IIITEACHER RECOMMENDATION

Email Address

If my child is selected for RSI, I will urge him or her to participate in CEE activities through undergraduate and graduate yearsof study. I know our support is essential. I will support and consider volunteering for CEE on our child's behalf.

PARENT/GUARDIAN

Parent/Guardian Signature

Parent/Guardian Last NameParent/Guardian Title (Mr., Ms., Mrs., Dr., Other)

Parent/Guardian Home Phone NumberParent/Guardian Daytime Phone Number

Parent/Guardian E-mail Address

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 Teacher Recommendations in sealed envelopes• Part IV: An official high school transcript and standardized tests scores with verification• Part V: Completed and signed applicant and parent/guardian release information• Application Processing Fee of $50 Enclosed Please waive the fee

(Please make checks payable to CEE)• Self-addressed stamped postcard for Enclosed Not enclosed

application receipt verification (optional)

All parts of the application should be enclosed in one envelope. Partial applications or applications received afterJanuary 15, 2010 (January 15, 2010 postmark is NOT acceptable) will be considered incomplete and will not beconsidered.

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

Applicant's Signature Date

RSI 2010 APPLICATION: PART VAPPLICANT AND PARENT/GUARDIAN RELEASES

APPLICANT

Complete electroncially and print off on printer, where possible. If necessary, please hand print very clearly. To be completed by studentDeadline: January 15, 2010

RSI 2010 APPLICATION: PART IVAcademic Documentation

Reminder, be sure to include the following:

• Official High School Transcript• PSAT math, verbal and writing scores (or SAT or ACT test results) showing evidence of exceptionalintellectual performance and potential

To be completed by student andparent/guardian

Deadline: January 15, 2010

Complete electroncially and print off on printer, where possible. If necessary, please hand print very clearly.