Name School Address Telephone Permanent Address Perm Telephone

Name: _________________________________ School Address: _____________________________Telephone: ________ Permanent Address: ____________________________ Perm. Telephone: ( )__________ Primary E-mail Address: __________________________ Expected Graduation Date: ____________ Cumulative GPA: ______ Academic Major: ______________ Student ID Number: _______ Have you been employed at URI previously? yes no If yes, where? ______________________________ A completed application package includes : Completed application cover sheet (this form) Unofficial copy of your student transcripts (may be printed from the web) Resume w/ cover letter Letter of recommendation , preferably from a faculty member Submit application to: Brianne Neptin 138 C CBLS APPLICATIONS ARE DUE BY 4: 30 PM ON FEBRUARY 22, 2013 As part of the application process you will be contacted by the Coastal Fellows Program Coordinator the week after the application deadline regarding your application status and whether you will proceed to the 1 st round of interviews. Based on your interview and areas of interest the coordinator will “match” you with prospective Coastal Fellows Mentors. The mentors will then interview prospective candidates and make the final choice of their Coastal Fellow.