2017 Summer Training Program in

Plant Diversity

New York Botanical Garden and Missouri Botanical Garden

June 12-30 (New York) and July 10-28 (St. Louis)

Application form (DEADLINE: April 15, 2017)

Name	Click here to enter text.
Street Address	Click here to enter text.
City, State, ZIP Code	Click here to enter text.
Primary Phone	Click here to enter text.
Alternative Phone	Click here to enter text.
E-Mail Address	Click here to enter text.
Ethnicity: (optional)	If other, please specify Click here to enter text.
Gender: (optional)
Birth date (mm/dd/yy): (optional)	Click here to enter text.

Personal Information

Academic Information

Institution (University/College/Institute)	Click here to enter text.
Current standing
Major	Click here to enter text.
Overall GPA	Click here to enter text.
Expected graduation year	Click here to enter text.
Courses in Biology you have completed	Click here to enter text.

Reference

Please indicate the name of someone who can provide a reference for you. This person may be an advisor, instructor, faculty member, etc.

Name	Click here to enter text.
Title	Click here to enter text.
Department	Click here to enter text.
Address	Click here to enter text.
Phone	Click here to enter text.
E-Mail Address	Click here to enter text.

Your motivation

Please explain why you wish to attend this course and your future professional goals (maximum of 250 words).

A completed application should be submitted by e-mail to Dr. Marcela Mora (marcela.mora@mobot.org) by Friday April 15, 2017. The Letter of Recommendation form should be submitted, by e-mail, directly by the referee, by the same date.