Summer Research Fellowship Application

Student Application

This application is designed to be completed in one sitting. In addition to submitting this online application, applicants must also submit two recommendations.

In addition to these recommendations, you must submit an MUSC transcript. This does not have to be an offiicial transcript. You must also submit documentation that you are current with your OSHA and HIPAA.

If you have any questions please contact Stephanie Brown-Guion, MSM, browngu@musc.edu, 843-876-2408.
Application Deadline: January 31, 2014.

* = required

I. Demographic Information

First Name *   MI Last Name *
Date of birth *(mm/dd/yyyy) Sex * Disabled *
Current Address
Address *
Address 2 *
City *
State *
Zip *
Phone *
Cell Phone
School E-mail Address *
Alternate E-mail Address
Citizenship *
If not a US Citizen, of which country are you a citizen? *
If you have a permanent resident alien "green" card, please provide the number on the card: *
Ethnicity Are you Hispanic (or Latino)? *
What is your racial background? *
Disadvantaged Minority? *
Social Media Use Do you use Facebook? *
Do you use Linked-In? *
Educational Background Beginning with the institution you are currently attending, please list the colleges/universities/high school you have attended. *
Name & location of school Major Expected Degree Graduation Date Overall GPA

Are you able to work starting May 19th continuously through July 25th, 2014? *

If you are currently an MUSC student, which college do you attend? *

II. Sponsor Information

Sponsor Name
(Last, First)
*
Sponsor Department *
Sponsor E-mail *

III. Project Information

Project Title *

Student Project Objectives*
(Briefly state Project Objectives)

Student Project Background*
(Summarize previous studies in the field and in the sponsor's laboratory and point out where additional studies - especially your proposed work - would add significantly to knowledge in the field)

Student Project Specific Aims*
(Outline exactly what you propose to do during the summer with some brief experimental details)

Miscellaneous

Have you had any previous research experience(s)? *
If yes, briefly describe the project (include mentor's name, time period of the research, any publications or presentations that resulted from the research):