Pacific Internship Programs for Exploring Science 

Check all that apply.

UH-HIP: University of Hawaii Hawaiian Internship Program
REU: Research Experience for Undergraduates
MASSIP: Micronesia and American Samoan Student Internship Program

Last name (family name/surname):
First name:
Middle name (optional):

Mailing Address:
Alternate Mailing Address (optional):

Home Phone:
Cell Phone (optional):
Alternate Phone (optional):

Email:
Important note: This program relies heavily on email correspondence.

Date of Birth: MM/DD/YYYY

Sex: Female
Male
Not Disclosed

Citizenship: United States
Permanent Resident
Other (FAS) (Country: )

Hawaii Residency: Hawaii Resident
Not a Hawaii Resident

If a resident, how many years have you lived in Hawaii?

Born in Hawaii: Born in Hawaii
Not born in Hawaii

This information is optional. Check all that apply.

What is your race? (check all that apply) White
Black, African American, Negro
American Indian or Alaskan Native ( Print name of enrolled or principal tribe: )
Asian Indian
Japanese
Native Hawaiian
Chinese
Korean
Guamanian or Chamorro
Filipino ( Are you Filipino of Hispanic descent? Yes No or Unsure )
Vietnamese
Samoan
Mexian, Mexican/American, Chicano
Puerto Rican
Cuban
Other Asian:
Other Pacific Islander:

Other Spanish/Hispanic/Latino:

Describe your current academic institution, if any. You must be a continuing student to be eligible for REU (i.e., student graduating in the Spring will not be eligible for the Fall REU program; REU applicants must be enrolled in an undergraduate program the semester following their summer internship).

Institution Name:

Institution Size: Less than 1,000
1,001-5,000
5,001-10,000
10,001-15,000
More than 15,000

Major:

GPA in Major:

Minor or certificate (if any/optional):

Cumulative GPA:

Expected Graduation Date: MM/DD/YYYY

Current Class Standing: Freshman
Sophomore
Juior
Senior
Other or Not Applicable

What are the dates of your summer break?

Do you have any summer plans that would interfere with a 11-week internship starting the Tuesday after Memorial Day (in May)? Yes
No
If yes, please explain:

Research areas of interest (check top 5): Botany
Chemistry
Ecology
Environmental Education
Environmental Law/Policy
Ethno-botany
Fisheries
Hawaiian Studies
Genetics/Molecular
Geology
GIS
Marine Science
Resource Management
Watershed/Aquatic Ecology
Zoology
Other interest(s):

Please select the highest level of education completed.

Mother: High School
Associates Degree
Bachelors Degree
Masters Degree
Ph.D. or similar
Other or none

Father: High School
Associates Degree
Bachelors Degree
Masters Degree
Ph.D. or similar
Other or none

Do you have any health conditions that may interfere with performing an internship requiring outdoor/physical activities (e.g., allergies or physical limitations)? Yes
No
If yes, please explain:

Do you have medical/health insurance? Yes
No

By typing my last name here, I certify that all of the statements and information provided in my application materials are true to the best of my knowledge.

By typing my last name here, I give the PIPES Office permission to contact my current or past instructors, advisors, and employers in regards to my performance in past/on-going related coursework/employment and my current academic standing within my institution.

Don't forget to submit the additional documents as requested on the application instructions page.