CCUS-STRP Application Form

The Southwest CCUS Training and Research Partnership (CCUS-STRP) is a research and training program focused on Carbon Capture, Utilization, and Storage (CCUS). This application form is for consideration into the CCUS-STRP program and is not an application for university admission.

We anticipate accepting approximately 30 undergraduate students into the program per year. Accepted trainees will be provided stipends, mentorship, and research opportunities. Please complete all required sections to submit this form.

Questions marked with an asterisk (*) are required.

CCUS-STRP Application Form

The Southwest CCUS Training and Research Partnership (CCUS-STRP) is a research and training program focused on Carbon Capture, Utilization, and Storage (CCUS). Please complete the required fields to apply for this opportunity. Questions marked with an asterisk (*) are required.

Biographic Information

First Name*:

Middle Name:

Last Name*:

Previous Name:

Email Address*:

Phone Number*:

Birthdate*:

Country of Citizenship*: Select Country United States Other

Sex: Female Male

Mailing Address

Country*: United States Other

Street*:

City*:

State*: Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Postal Code*:

Race/Ethnicity (Optional)

Colleges and universities are asked to describe the ethnic/racial backgrounds of their students and employees.

Are you Hispanic or Latino? Yes No

Check one or more groups you identify with:
American Indian or Native Alaskan
Asian
Black or African American
Hawaiian/Pacific Islander
White/Caucasian

Educational Background

Graduate School Information:

All Colleges Attended*:

Experience Background

Employment History:

Supplemental Materials

Transcripts*:

Personal Statement*: