SENIOR QUESTIONNAIRE 2024 Heyl Scholarship Senior Questionnaire If you are a Heyl Scholar that will be graduating in 2024, please complete the following questionnaire. Step 1 of 8 12% I am a graduating Heyl scholar from… * RequiredKalamazoo CollegeWMU Bronson School of Nursing Name * Required First Last Email * Required High School * RequiredWhat high school did you graduate from?Did you attend KAMSC? * Required Yes No Undergraduate Major * RequiredWhat is your major or majors?Undergraduate MinorsList any minors or concentrations. Co-CurricularStudy Abroad * RequiredDid you study abroad domestically or internationally? Yes No Where did you study abroad? * RequiredPlease list the state, country, etc. What did you gain from studying abroad?Did you earn college credit, did you see a different health care system, enhanced cultural competence, etc…Internship * RequiredDid you conduct an internship or externship as an undergraduate? Yes No Where did you intern/extern? * RequiredPlease list the company or agency. What did you gain from this intern/externship?Describe the internships or externships experiences you conducted as an undergraduate. Be sure to include any skills gained. Clinical * RequiredDid you conduct clinical experiences as an undergraduate outside of the nursing programs course required clinicals. Yes No Where did you conduct this/these clinicals? * RequiredPlease list the hospital, company, agency. What did you gain from this clinical?Describe the clinical experiences you conducted as an undergraduate. Be sure to include any skills gained. Heyl Summer Research Grant * RequiredDid you receive a Heyl Summer Research Grant? Yes No Did you use the Heyl Summer Research Grant funds to conduct your SIP? * Required Yes No With whom did you work? * RequiredWhen you received the Heyl Summer Research Grant, who was your research mentor?Please list any sports, clubs, student organizations, and/or leadership roles that you have held as an Heyl Scholar. Senior Integrated ProjectSIP Discipline * RequiredSIP Supervisor/PI * RequiredSIP Location * RequiredPlease list the institution, agency, or company name. SIP City * Required City State / Province / Region Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands SIP Title * RequiredSIP Project Description/Abstract * Required Senior ThesisDid you conduct a Senior Thesis? * Required Yes No Senior Thesis Discipline * RequiredSenior Thesis Supervisor/PI * RequiredSenior Thesis Location * RequiredPlease list the institution, agency, or company name. Senior Thesis City * Required City State / Province / Region Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Senior Thesis Title * RequiredSenior Thesis Project Description/Abstract * Required EmploymentPlease note that the information in this section will only be seen by the Executive Director and shared with the Heyl Science Scholarship Fund Board Members.Work * RequiredDid you work an external job as an undergraduate Heyl scholar? Yes No On average how many hours a week did you work? * RequiredWhy are you working? * RequiredPlease enter the reason that you are working (ie: if I do not work, I won’t be able to pay my rent). Mentorship & GuidanceThe Heyl Fund is hoping to provide you with the opportunity to honor a faculty member that has impacted your educational journey. These awards are for STEM faculty at K College or Nursing faculty at WMU. Is there are faculty member that has impacted your educational journey? * RequiredFor graduating Heyl Scholars from K, this person should be a STEM faculty member. For graduating Heyl Scholars from WMU, this person should be a WMU Bronson School of Nursing faculty member. Yes No Faculty Mentors Name * RequiredPlease describe how this person has impacted your educational journey? * RequiredThese words will be read on your behalf although the Fund would like for you to present the award if the person is in attendance. Next Steps & ReflectionPost-graduation Plans * RequiredHow did the Heyl Scholarship make a difference in your undergraduate education? * RequiredWhat is one piece of advice you would provide to an incoming Heyl Scholar?What is one thing the Heyl Science Scholarship Fund could change, do, or provide in order to further impact and enhance future scholars expeirences as an undergraduate?Personal Image * RequiredPlease upload a current photo of yourself doing something you enjoy. This image will be used to highlight you at the Spring Celebration. Accepted file types: jpg, jpeg, png, gif.Addtional CommentsPlease feel free to share any additional comments. Δ