Full Application Form
Application Deadline January 31, 2015
Idaho INBRE
2015 Summer Western INBRE Visiting Fellow Program
Note: To be eligible for an INBRE Undergraduate Summer Fellowship, you must be graduating
December 2015 or later. Students graduating in May or August 2015 will not be eligible in 2015.
The Western INBRE Visiting Fellow Program at the University of Idaho is an opportunity for
undergraduate students from Alaska, Hawaii, Montana, New Mexico, Nevada, or Wyoming to
participate in an intensive 10-week summer research experience in the laboratory of an Idaho
researcher.
Enter name and contact information where
we will be able to reach you in March/April.
Please enter your current education
information:
Name:
Current Educational Institution:
Complete Address:
Major:
Phone:
Expected Month and Year of Graduation:
Email:
Current Grade Point Average:
Where did you graduate from high school?
Name of High School:
City:
Zip:
State:
Please enter your full permanent residence
address (non-school hometown):
City:
Street:
State:
Zip:
What is the highest level of education your
parents have attained? (Please enter one
choice for each parent – High School, Some
College, Assoc. Degree, BA or BS, MA or
MS, PhD, MD, or any other degree as
appropriate.
Mother:
Father:
What is your gender? M or F
Are you a citizen or permanent legal resident of the United States? Yes or No
Race and Ethnicity: We are required by Federal law to request this information for statistical
reporting purposes. Your response is voluntary.
Do you consider yourself to be Hispanic/Latino(a)? Yes or No
Select one or more of the following racial categories to describe yourself:
American Indian
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Other (please specify):
What are your current education and career plans? If your plans include graduate school,
will you consider enrolling in an institution in Idaho, Alaska, Hawaii, Montana, New Mexico,
Nevada, or Wyoming?
Describe the research experience you have had.
What do you hope to gain from an INBRE Summer Research Fellowship?
Please write a statement about obstacles you have overcome to pursue your educational
goals.
Select up to three mentors from the school(s) you would like to apply to:
University of Idaho
1.
2.
3.
1.
2.
3.
Idaho State University
1.
2.
3.
Boise State University
I certify that I fully understand the questions on this form and that information given in this
application is true and correct. If I am selected as an INBRE Fellow, I give the INBRE program
permission to include my name, institution, major and hometown in statewide press releases
announcing all Fellows.
Name:
Date:
Submission Instructions
Application Form
Idaho INBRE
Application deadline January 31, 2015
Summer 2015 Western INBRE Visiting Undergraduate Fellow Program
Steps to submit the Fellows Application:
1. Be a student enrolled at a college or university in Alaska, Hawaii, Montana, New Mexico,
Nevada, or Wyoming who will be graduating on or after December 2015. Students graduating in
May or August 2015 will not be eligible in 2015.
2. Complete and submit the application form.
3. Attach current transcripts
Transcripts can be obtained through the Registrar’s office of institutions attended by the
applicant. Unofficial transcripts may be used, but formatting must be easily readable.
4. Two confidential letters of reference USING the REFERENCE FORM found on the
Fellows application page.
Request two confidential letters of reference. Please ask letter writers to complete the
reference form online at http://inbre.uidaho.edu/references. Once your letter writer
creates an account they will be able to save the reference forms they are working on.
Submitted references are due by the application deadline, January 31, 2015.
The Idaho INBRE Fellowship program is a competitive program. The number of applications we
receive will exceed the available Fellowships. In order to be considered for a Fellowship we
must receive your completed application including transcripts and letters of reference by the due
date of January 31, 2015. We cannot consider incomplete packets.
If you have questions, or difficulties completing this form, please contact the INBRE office at
(208) 885-5373 or inbre@uidaho.edu.
The Idaho INBRE Program is supported by an Institutional Development Award
(IDeA) from the National Institute of General Medical Sciences of the
National Institutes of Health by Grant #P20GM103408.