Name:
Expected Date of Graduation:
e-mail address:
School Address:
Home Address:
Cell or School Telephone Number:
Home Telephone Number:
Date of Birth:
Citizenship: (must be US citizen or permanent resident to receive a stipend--indicate if permanent resident)
Institutions of Higher Learning Attended:


Major Area of Study:

List awards, distinctions, scholarships, rankings on Putnam exams, etc.











List the names and electronic addresses of your references.






Describe your academic interests.






What are your long-term career plans?





What experience do you have that will especially qualify you for this position?















Additional Remarks: (Please attach supplementary pages, if necessary.)























Transcripts (they need not be official) of all college/university work completed to date, letters of recommendation, and the completed application form should be sent to: Joseph A. Gallian, Department of Mathematics & Statistics, University of Minnesota Duluth, Duluth, Minnesota 55812. Deadline for RECEIPT of materials: February 10, 2010. Copies of transcripts, letters of recommendation and the application form may be submitted via e-mail (jgallian@d.umn.edu), fax (218-726-8399) or US mail.