CSUN-UCLA Bridges to Stem Cell Research Application
Applications are due February 15, 2016 via email to Dr. Cindy Malone, cmalone@csun.edu
Please type your name into the subject box of the email and attach this document.
A complete application consists of:
A filled out checklist!
A typed completed Application Form including:
I. Demographic Information
II. Education
III. All Science Grades and GRE Scores (Undergraduates leave GRE scores blank)
IV. Career Goals
V. The personal statement describing your personal background, your career
goals, and your reasons for wishing to participate in the CSUN-UCLA Bridges
program.
VI. The statement of research experience.
VII. Identification of two faculty references: if possible, one should be a current or
previous faculty research mentor who can address your intellectual and personal
suitability for the program and, the other, a Science course faculty member.
Graduate students only: Before the Spring 2015 deadline, you must complete the Biology
department application for the Biology Master’s Program with your interest to the Bridges
Program indicated in the “faculty mentor” section. See the following link for information and
application. To be completed by. http://www.csun.edu/%7Ehfbio002/grad/gradfaq.pdf
Graduate students only: Before the Spring 2015 deadline, you must complete the application to
the University. See the following link for information and application.
http://www.csumentor.edu
Inquiries about the CSUN-UCLA Bridges to Stem Cell Research Program are welcome and
should be directed to Cindy Malone via email at cmalone@csun.edu
CSUN-UCLA Bridges to Stem Cell Research Application
I am a current CSUN Undergrad Student
I am a current CSUN Graduate Student
CSUN ID#:
CSUN ID#:
Major:
Major:
I am concurrently applying to the
CSUN Graduate Program
I am applying for cohort Fall:
2016
I. DEMOGRAPHIC INFORMATION
Name:
Local Mailing Address:
Phone Number(s): Home
Cell
E-mail Address:
Date of Birth:
Eligibility (check one):
U.S. Citizen
Permanent Resident Alien
Gender:
Male
Female
Ethnicity (voluntary information):
Caucasian
Hispanic
African American
Pacific Islander
Native American
Other
International
Asian
Decline to state
II. EDUCATION
University:
GPA in Science Courses:
Overall GPA:
Undergrad Degree (or expected, BA/BS):
Date of Graduation (or expected):
I have taken/currently enrolled in Biol 577/L Cell
and Tissue Culture and Lab
I have taken a lab course in Cell and Tissue Culture
at a different institution (provide name)
CSUN-UCLA Bridges to Stem Cell Research Application
III. GRE AND ALL SCIENCE COURSE GRADES FORM
Undergraduate University:
General GRE Date Taken
Date Biology GRE Taken
# Scores: Verbal
Quant
Writing
# Scores: Cell Bio
Physio
Eco
Percentile: Verbal
Quant
Writing
Percentile: Cell Bio
Physio
Eco
Subject/No.
Course Title
Letter
Units
Points
College Abbrev.
CSUN-UCLA Bridges to Stem Cell Research Application
CSUN-UCLA Bridges to Stem Cell Research Application
IV. CAREER GOALS
Graduate School (MS/Ph.D.)
Medical/Dental/Pharmacy School
Career in Biotech/Pharmaceutical Company
Other
V. PERSONAL STATEMENT
In the space provided, please briefly describe your background, why you wish to participate in the Bridges
program, and how it will benefit your educational AND career goals (500 words).
CSUN-UCLA Bridges to Stem Cell Research Application
VI. RESEARCH EXPERIENCE
In the space provided, please describe any previous research experience. State the objective or your research,
the approaches you used, and what conclusions you were able to make, if any. List any publications and
presentations for which you were an author or co-author (500 words).
CSUN-UCLA Bridges to Stem Cell Research Application
VII. REFERENCES
(please identify two faculty references who know your abilities and interests well).
Reference name
Dept./Institution
Email and phone #