Course Application Deadline: Day before course starts Financial Aid Application "Priority Date:" March 15 In addition to this application form, two pieces of supplementary material may be required. 1. Transcripts: Copies of all your college transcripts are required. Unofficial transcripts are fine. UVA students - By submitting this application you are giving us permission to access your UVA transcripts directly. You need not send them to us.2. Letter of recommendation ONLY if you are requesting financial assistance: Submit one letter of recommendation from a faculty member or similar academic instructor or advisor who knows you and your potential. Referee should send letter directly to MLBS. Personal Information Name First * Middle Last * Current Contact Information Address Line 1 Address Line 2 City State/Province Zip/Postal Code Phone * Email * Permanent or Home Contact Information Address Line 1 * Address Line 2 City * State/Province * Zip/Postal Code * Other Email Emergency Contact Name * Phone * Health, Safety, Comfort, Personal, and Dietary Needs: MLBS is a remote field station with limited facilities, access, and communications. Many activities at MLBS occur out of doors in unpredictable and demanding weather and physical conditions. Some modern conveniences are unavailable. Emergency medical response time is 30 minutes or more. Please indicate here (or contact us at 540-626-7196 or mlbs@virginia.edu) any medical, dietary, or personal needs that may require special consideration or accommodation (e.g. disability, medication storage, life threatening allergy, personal comfort needs). Please tell us anything else about yourself we might find useful in providing for your safety, wellbeing, and comfort at the Station. Housing requests or concerns Sex / Gender Identity (for housing assignment) * Female Male Other / Preferred Pronouns? Sex / Gender Identity (for housing assignment) Other / Preferred Pronouns? Age when you arrive at MLBS * 17 or younger 18 - 20 years old 21 or older Student Status * Undergraduate Graduate Other... Student Status Other... Current College or University * Expected Graduation * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20192020202120222023202420252026202720282029 Major * Overall GPA * Major GPA * Please list all colleges or universities attended. Include dates and any degrees Do you qualify for University of Virginia "in-state resident" fees? * Yes No What is your state or country of residence? How did you learn about Mountain Lake? Check all that apply Brochure, Poster or Display made available through my school Brochure sent directly to me Web site Current or former Mountain Lake student Current or former Mountain Lake faculty Instructor or Advisor On-line database or student opportunities clearing house Other... How did you learn about Mountain Lake? Check all that apply Other... If you have been to Mountain Lake Biological Station before, when? And in what capacity? Course Selection Registration is limited to one course per session. Session I FIELD BIOLOGY OF FISHES FIELD HERPETOLOGY No Session I Course Session II PLANT DIVERSITY, EVOLUTION, AND CONSERVATION No Session II Course Session III FIELD BIOLOGY OF INSECTS No Session III Course Financial Assistance Request (optional) Complete this section only if you wish to be considered for MLBS financial assistance (this is not at all related to any other financial aid award you may have). Funds are granted to help defer tuition, housing, and/or dining costs while taking a class at MLBS. Awards are made while funds are available and are based on academic record and financial need. A statement of need and letter of recommendation are required. Financial aid recipients will be called upon to assist with tasks and special work projects each week in Station buildings or on the grounds. Weekend projects may be required. Work load varies over the summer, but efforts are made to accommodate class schedules. Review of applications for financial aid begins March 15. aid_request Check to request financial assistance Statement of Financial Need: Please provide a brief statement of financial need as it relates to your ability to enroll in a course at MLBS. Supplementary Material 1. Transcripts: Copies of all your college transcripts are required. Unofficial transcripts are fine. UVA students - By submitting this application you are giving us permission to access your UVA transcripts directly. You need not send them to us.2. Letter of recommendation, ONLY if you are requesting financial assistance: Submit one letter of recommendation from a faculty member or similar academic instructor or advisor who knows you and your potential. Referee should send letter directly to MLBS. Send all supplementary material to: Mountain Lake Biological Station University of Virginia P.O. Box 400327 Charlottesville, VA 22904-4327 eml: mlbs@virginia.edu (do not use for sensitive personal material) fax: 434-297-4907 Thank you very much! For questions about the program or your application please call 434-982-5486 or email mlbs@virginia.edu. Mountain Lake Biological Station values diversity and is committed to equal opportunity and affirmative action in all its programs. When you are ready . . .
