RESEARCH APPRENTICESHIP APPLICATION FORM

ANY STUDENT WANTING TO ENGAGE IN A RESEARCH APPRENTICESHIP MUST:

* be a matriculated Warner student accepted into a Warner degree or certificate program;

* select a Warner or UR faculty member (tenured, tenure-track, clinical, or visiting) to work with

* complete this application AND register online for the course; the form alone will not register student;

* contact Warner Registrar for instructions if completing more than one research apprenticeship per term;

* submit form by term deadlines below (if date falls on weekend, following Monday is deadline):
> Fall - September 15th
> Spring - February 1st
> Summer - June 15th

Today's Date: Today's Date: / MM / DD YYYY
Year & Term you're registering for (select one each)

Year & Term you're registering for (select one each) 2024 2025 2026 Fall Spring Summer
STUDENT'S PERSONAL INFORMATION
Last Name
First Name
Middle Name (or initial)
Nickname (if used)
Student ID#--if unknown, contact Warner Registrar
Must be 8 digits. Currently Entered: 0 digits.
Preferred E-mail
Advisor Name
Advisor's E-mail
COURSE INFORMATION
Course Number for Research Apprenticeship

Course Number for Research Apprenticeship ED 496 Master's ED 596 Doctoral
Credit Hours (Units)
Must be a number less than or equal to 6.
Instructor Name
COURSE DESCRIPTION
Primary objectives of this Research Apprenticeship:
Description of work student will complete for Apprenticeship:
How will the Research Apprenticeship be assessed:
SIGNATURE VERIFICATION:
Student's Electronic Signature: by typing my FULL LEGAL NAME in the field below, I affirm that I have received (or will immediately seek) the instructor's approval to complete this Research Apprenticeship:

I understand this is a legal representation of my signature.

RESEARCH APPRENTICESHIP APPLICATION FORM

RESEARCH APPRENTICESHIP APPLICATION FORM

STUDENT'S PERSONAL INFORMATION

COURSE INFORMATION

COURSE DESCRIPTION

SIGNATURE VERIFICATION: