Enter course number if you received class credit for your research:

Affiliation: NCSU

Provide a brief description of your research project:

Faculty Advisor/Mentor Name Email

Advisor/Mentor's signature and date if research was not for credit:

hǘƘŜNJ

Email  Address  Name   Student  ID  #

Please provide us with a non-NCSU email address where we can contact you to keep in touch. We will not share your email address with any other party.