Online Application Form

GEBS Summer Scholars Program

Important Program Information

Summer Program Dates (Summer 2009): June 1- August 7 (10 weeks).

Application Deadline: All application material for the Summer of 2009 must be received by March 1, 2009. Early applications are encouraged, since applications are reviewed on a rolling basis.

The GEBS Summer Scholars Program is aimed at providing research opportunities in all aspects of Biological or Biomedical Research to undergraduates may be considering applying to graduate (PhD) programs. The following groups of applicants are encouraged to apply for this program:

Students interested in the Ph.D. (Students who intend to apply to medical school should contact the Strong Childrens' Research Center summer program.)
Students that are US citizens, permanent resident aliens, or foreign students with visas from their host institutions.
Students from groups that are under-represented in the biological sciences. These groups include students with disabilities, students from certain racial/ethnic groups (see below), first-generation college students and individuals from socioeconomically disadvantaged backgrounds.
NIH recognizes racial/ethnic groups that are significantly underrepresented at advanced levels of science and engineering in the U.S. to be as follows: Native Americans (including American Indians and Alaskan Natives), African-Americans, Hispanics, and Native Pacific Islanders.
Students with a potential interest in attending graduate school at the UR are especially encouraged to apply

Personal Information

First Name:
Middle Name :
Last Name:
Preferred Nickname (if applicable):
Date Of Birth (MM/DD/YYYY):
Gender:	Male Female

Citizenship

US Citizen

Permanent Resident Alien

Foreign

If foreign, please state the type of visa you hold and your country of citizenship:

Present Address

Street/Address:
Apt./Box # :
City:
State/Province:
Country:
Zip Code :
Telephone:
Email address :

Permanent Address (if different from above)

Street/Address:
Apt./Box # :
City:
State/Province:
Country:
Zip Code:
Telephone:
Email address :

Education Record

University:
Address:
Degree (BS/BA):
Current GPA:
Area of Degree:
Matriculation Date:
Expected Date of Graduation:

If you have attended more than one undergraduate institution, please list the most recent above and include the next most recent below:

University:
Address:
Degree (BS/BA):
Current GPA:
Area of Degree:
Matriculation Date:
Expected Date of Graduation:

Please list three relevant science courses taken during the last year:

Course		Grade
Course		Grade
Course		Grade

Please indicate any honors or awards received (900 characters max):

We would like to know more about you. In your own words, please describe your interests and intentions below.

Please describe any prior research experience you have participated in (900 characters max):

Please explain why you wish to participate in this program (900 characters max):

Please describe your scientific interests (900 characters max):

Please describe your career goals (900 characters max):

Information to help us plan for the summer

Please indicate whether you intend to take the following standardized tests in the future:

GRE General Test

MCAT

Both

If we were to offer a GRE or MCAT preparatory course, and you could take only one of these two courses which one would you wish to take?

GRE

MCAT

If we could offer you the opportunity to have a courtesy interview with a graduate program director here at UR during the summer, would you be interested in doing so?

Mock-graduate school interview:

Yes

Research Project Information

Please list the names of three possible mentors at the University of Rochester Medical center:

First Mentor:
Second Mentor:
Third Mentor:

Recommendations

Please indicate the names of two professors who have agreed to write letters of recommendation:

Name:		Title:
Name:		Title:

Also, if you have a pre-med advisor, please give her/his name:

Name:

Title:

Important

After submitting this form, please send a copy of your official college transcripts (one from each college you have attended) and two letters of recommendation to:

Juliet Miller
Summer Scholars Program
University of Rochester Medical Center
601 Elmwood Avenue, Box 316-S
Rochester, NY 14642

Please note that only original documents in signed and sealed envelopes will be accepted.
Only complete application packets including recommendations and transcripts will be reviewed.

Optional Information

For U.S. citizens and permanent residents only.

How would you describe yourself? (Please check one).

African American
American Indian or Alaskan Native
Pacific Islander (including Fijian, Hawaiian, Samoan)
Asian (including Indian subcontinent)
Hispanic (including Mexican American; not Puerto Rican)
Puerto Rican
White, Anglo, Caucasian American (non-Hispanic)
Other

Were you formerly a member of a Ronald E. McNair Program?

Yes

Are you a first generation college student?
(this means that neither of your parents has a B.S./B.A. or equivalent 4-year degree)

Yes

Are you from a low-income family, as defined by federal guidelines?
(click here to see a relevant income table)

Yes