Example Application for SRIP

Example Application for SRIP



This is an example application.

You must use the on-line form to apply to the program.
PAPER OR FAXED APPLICATIONS WILL NOT BE ACCEPTED
Applicant FAQ

If you are ready to provide all of this information now, including both your Interests and Goals Statements, please proceed to the on-line application.


Personal Information
Last 4 digits of Social Security Number (such as 3333):
Date of Birth: (MM/DD/YYYY)
Gender:
Last Name(s)
First, Middle Name(s)
Are you a U.S. Citizen?:
If no, are you a permanent resident of the U.S.?
If you are not a Permanent Resident or U.S. Citizen, please enter your current visa type here:
Race/Ethnicity:

Current Address Information

(Your school address and contact information)
Address Line 1:
Address Line 2:
City:
State/Country: Zip Code:
Current Telephone #:
Current Email:
This address information will be current until what date?

Permanent Address Information

(Address of parent, relative or other permanent address at which you can always be contacted)
Address Line 1:
Address Line 2:
City:
State/Country: Zip Code:
Permanent Telephone #:
Other Email:

Education Information
High School Name & Date of Graduation:
City & State:
Undergraduate Institution:
Year In School Major:
GPA (Total): & GPA (In Major):
List any honors, fellowships or special awards (e.g. MARC Scholar, NSF
or Howard Hughes Fellow, College or University recognition of achievement:

I am a first generation college student.
My family has an annual income below established low-income thresholds.
For guidelines visit this site:
http://aspe.hhs.gov/poverty/
I have received one of the following loans or scholarships
(Respond to all that apply):
Health Professional Student Loans (HPSL)
Loans for Disadvantaged Student Program
Scholarship for Individuals with Exceptional Financial Need
Federal Disadvantaged Assistance
You may provide us with information on other types of loans or aid that you have received in the field below:
I am an individual who has a physical or mental impairment that substantially limits one or more major life activities.

You may submit an optional statement that further describes your financial, historical, physical, mental circumstances or limitations.
Indicate your areas of research interest in order of
preference from the three lists below:


Area of Interest Preference indicate #1 #2 & #3

Biodefense
Bioinformatics
Biophysics
Cancer
Cardiovascular Biology and Disease
Cellular Growth/Regulation
Computer Modeling
Diabetes
Endocrinology
Enzymology
Epigenetics
Gene Expression
Gene Regulation
Global Health
Hypertension/Renal Disease
Immunology
Infectious Diseases
International Health Disparities
Molecular Genetics
Molecular Pharmacology
Neuroendocrinology
Neuroscience
Oncogenes
Parasitology
Protein Structure and Function
Receptor Biology
Signal Transduction
Stroke
Vaccine Development
Vascular Disease
Virology


Two Statements Required:

1. Past Research Experience and Long Term Goals (250 Maximum)
Compose a paragraph detailing any past experience in a research laboratory, even that associated with a class. This is your opportunity to explain your educational aspirations and why you want to participate in SRIP. Some questions you might consider are: What are your academic and/or career goals? How have your past experiences and background influenced your goals? How will SRIP help you achieve your goals? What do you expect to gain from an SRIP experience?
(paragraph box for your text here)

2. Statement of Research Interest (125 words maximum)
In order to identify potential faculty mentors for you, the SRIP reviewers need to know what areas of research interest you.  Please describe the area(s) that you would like to explore and why this research appeals to you.  If familiar with research conducted at UVA, please list the faculty, departments, programs and/or research centers, with whom you would be interested in executing a summer project.  
(paragraph box for your text here)

There will be a button here on the application (click it only once, please!) which will submit your on-line application information and then take you to a page that provides instructions on how to submit SRIP Application Parts B and C.

B) Official Transcripts
C) Reference Forms

B-C Instructions Page

This is an example application.

You must use the on-line form to apply to the program.
PAPER OR FAXED APPLICATIONS WILL NOT BE ACCEPTED

If you are ready to provide all of this information, including both Interests and Goals Statements now, please proceed to the on-line application.

Online Application