Application for Kenan Fellows
Summer Undergraduate Internship
INSTRUCTIONS: Fill out this form completely, scan to PDF
and email to TSRIFLED@scripps.edu.
PERSONAL INFORMATION
NAME: (Last, First, M.I.)
DATE OF BIRTH:
GENDER:
FEMALE
MALE
PERMANENT ADDRESS:
ADDRESS WHILE AT SCHOOL:
Dates you are at this address:
MOBILE PHONE:
(
)
HOME PHONE:
(
)
(optional)
EMAIL ADDRESS:
ETHNICITY: (optional)
African American
Native American
Native Pacific Islander
Decline to state
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Asian
Caucasian
Other:
Hispanic
Application for Kenan Fellows Summer Undergraduate Internship · Page 2 of 3
If hired, can you provide proof that you are a citizen or national of the United States of America, a lawful permanent resident, or an
alien authorized to work in this country?
YES
NO
If you hold a visa that authorizes you to work in the US, list visa type and expiration date:
Visa Type:
Exp. Date:
Please list the details of your previous Kenan Fellows summer internship with Scripps Florida:
Year:
Lab (list by faculty name):
Mentor, if different (person you worked with daily):
If hired, do you have satisfactory housing arrangements for the duration of the summer program, or do you wish to utilize the
on-campus housing at the FAU campus next to Scripps Florida? (On-campus housing is provided free of charge to all interns)
I have housing arrangements I wish to use the FAU housing
ACADEMIC HISTORY
List all schools attended:
School Name/Place
Start Date
Degree
Major
End Date or Expected
Date of Conferral
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EMPLOYMENT HISTORY
List any relevant employment history:
Employer Name/Place
Start Date
Job Title & Description
End Date
Do you have any other schedule commitments that may conflict with the dates of the summer internship program?
YES
NO
GRADE POINT AVERAGES
High School GPA ( _/4.0)
Overall GPA:
Undergraduate GPA ( _/4.0)
Overall GPA:
Major GPA:
SUPPORTING DOCUMENTATION CHECKLIST
Email the following materials to TSRIFLED@scripps.edu by February 15: (PDF documents preferred)
University Transcripts
Submit a written statement reflecting your purpose in applying to the Kenan
Undergraduate Program and specifically your reason for selecting The Scripps Research
Institute. Please include what benefits you hope to gain from your research internship.
Submit a written statement describing your laboratory experience. Please also include
a statement about any Scripps Research faculty members who are working in your
area of interest.
Submit a written statement describing your extracurricular interests and hobbies.
Letter of Recommendation 1
Letter of Recommendation 2
Your Updated Résumé