First Name (legal)
* must provide value
Preferred Name (if applicable)
Last Name
* must provide value
Email Address
* must provide value
Phone Number
* must provide value
Expected Street Address during Summer 2023 (if unknown, enter current street address)
* must provide value
Expected Address: City (enter current if unknown)
* must provide value
Expected Address: State (enter current if unknown)
* must provide value
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Expected Address: Zip Code (enter current if unknown)
* must provide value
Do you have a mailing address different from your expected summer address (or, if unknown, current address) that you would like us to send your stipend check to? (Please note that your stipend check may arrive after the 8-week program concludes, depending on processing time. Please make sure you include an address that you will have access to both during and after the summer.)
* must provide value
Yes
No
Mailing Street Address
* must provide value
Mailing Address: City
* must provide value
Mailing Address: State
* must provide value
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Mailing Address: Zip Code
* must provide value
Birth date
* must provide value
Today M-D-Y
Please describe your ethnicity
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Hispanic or Latino
Not Hispanic or Latino
Prefer not to answer
Please describe your race (Select all that apply)
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American Indian or Alaska Native
Asian or Asian American
Black or African American
Native Hawaiian or Pacific Islander
White
Prefer not to answer
What is your gender identity? (Select all that apply; learn more at https://lgbt.hms.harvard.edu/terminology)
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Cisgender man
Cisgender woman
Transgender man
Transgender woman
Genderqueer or non-binary
Questioning or unsure
Prefer not to answer
Other (Please specify below)
Please specify gender identity
* must provide value
Please describe your pronouns (Select all that apply)
* must provide value
She/her/hers
He/him/his
They/them/their
Other (Please specify below)
Please specify pronouns
* must provide value
Educational stage in Fall 2023 (Please note: You must be a current undergraduate or graduate student who will continue to be enrolled in Fall 2023)
* must provide value
Undergraduate: Sophomore
Undergraduate: Junior
Undergraduate: Senior
Graduate (Please specify below)
If you answered "Graduate" in previous question, please note what year of grad school you will be in during Fall 2023.
* must provide value
Name of school you will be attending in Fall 2023
* must provide value
Major or degree program
* must provide value
Expected graduation date
* must provide value
Today M-D-Y
Most recent GPA (out of 4.00)
* must provide value
Are you a citizen from an OFAC-sanctioned country? (See this website for more information: https://home.treasury.gov/policy-issues/financial-sanctions/sanctions-programs-and-country-information)
* must provide value
Yes
No
What are your career goals? (1-2 sentences, 100 word limit)
* must provide value
Please list your most relevant prior experiences (e.g., student organizations, relevant coursework or skills, certifications). This is not intended to be comprehensive, so please list no more than 5.
* must provide value
Please list your proficiency in the following computational skill: R Programming
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following computational skill: Python programming
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following computational skill: SAS programming
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following laboratory skill: DNA/RNA extraction
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following laboratory skill: Flow cytometry
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following laboratory skill: Gel electrophoresis
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following laboratory skill: PCR
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following laboratory skill: Plasmid preparation
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following organizational skill: EndNote
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following organizational skill: EPIC or other electronic health records
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following organizational skill: Microsoft Office (Word, Excel, etc.)
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following organizational skill: Microsoft Access
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following skill: Data entry
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following skill: Literature review
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following skill: Medical translation
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficiency in the following skill: Patient interview
* must provide value
Not Applicable
Novice
Intermediate
Experienced
Please list your proficient programming languages (e.g., R, SPSS), laboratory techniques, or soft skills, if any, that were not mentioned above.
* must provide value
One of the goals of this program is to increase diversity in the biomedical research community by recruiting individuals from groups historically underrepresented in the sciences. In this context, you are asked to describe your background, prior experiences, and career goals. Briefly, who are you, what are you passionate about, and where do you want to go in the future? (1-2 paragraphs, 500 word limit)
* must provide value
If selected, would you have access to a computer and broadband internet to facilitate work and teleconferencing?
* must provide value
Yes
No
Unsure
Given the current status of the COVID pandemic, the summer research internship is slated to be hybrid, with some mandatory in-person meetings. However, as circumstances change, there may be a potential opportunity for you to continue the internship past the summer and to work on campus in the future. Would you be interested in such an opportunity?
* must provide value
Yes
Yes, but only during the summer
Yes, but only during the academic year
Unsure
No
Would you be interested, if given the opportunity, in continuing the internship into the academic year remotely (with a lower time commitment, e.g., 10 hours/week)?
* must provide value
Yes
No
Unsure
Have you received CITI certification training in the past 3 years?
* must provide value
Yes
No
If you have received CITI certification training, please upload your certificates as 1 PDF file. Please save the file in the format "LastName_FirstName_CITITraining.PDF" (e.g., Doe_Jane_CITITraining.pdf)
* must provide value
The start date for the program is Monday, June 12. The end date is Friday, August 4. Please check the box to acknowledge you understand the internship is 40 hours a week for 8 weeks from 8:30 - 5 pm ET.
* must provide value
I understand.
Please upload your transcript from your current academic institution. Unofficial transcripts are acceptable. Please save the file as a PDF and name as "LastName_FirstName_Transcript" (e.g., Doe_Jane_Transcript.pdf).
* must provide value
Please upload your CV/resume. Please save the file as a PDF and name it "LastName_FirstName_CV" (e.g., Doe_Jane_CV.pdf).
* must provide value
Recommender's Full Name
* must provide value
Recommender's Email Address (We recommend using their official, institution email address)
* must provide value
Recommender's Title
* must provide value
Recommender's Institution
* must provide value
By typing your full name below, you acknowledge that you have read the program requirements and agree to fulfill all requirements, which include working for the entire program duration of 8 weeks, 40 hours a week, attending all program meetings, and completing a survey at the end of the program.
* must provide value
Submit
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