Astro SURP Application 2024

First Name

Last Name

Optionally, please list your pronouns (https://www.mypronouns.org/what-and-why)

OSU Email Address (name.#@osu.edu)

Phone Number (e.g. xxx-xxx-xxxx)

The Department aims to actively track diverse representation and encourages applications from students who are members of underrepresented groups. If you identify with any of the groups below, you may optionally disclose this information by checking the appropriate box. You may select all options that apply to you. What you mark here is not considered in admissions decisions.

First-generation college students
Gender minorities (women, nonbinary people, genderfluid people, etc.)
International students
LGBTQ+ students
Racial and/or ethnic minorities
Students with disabilities
Students from low-income backgrounds
Other: Please feel free to describe below.