Full Application Form Application Deadline February 7, 2014 Idaho INBRE Summer 2014 Undergraduate Fellowship Program Note: To be eligible for an INBRE Undergraduate Summer Fellowship, you must be graduating with a Bachelor’s degree no earlier than December 2014. Students graduating with a Bachelor’s degree in May or August 2014 will not be eligible in 2014. Choose the Institution you are applying to: a. Boise State University b. Boise VA Medical Center c. Brigham Young University - Idaho d. The College of Idaho e. Idaho State University f. Lewis-Clark State College g. Northwest Nazarene University h. University of Idaho 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: Expected Month and Year of Graduation: Phone: Current Grade Point Average: Email: 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 are your current education and career plans? If you are currently a student at a community college, do your plans include transferring to another Idaho school to complete your Bachelor’s degree? If you are planning to go to graduate school, are you considering enrolling in an institution in Idaho? Describe the research experience you have had. What do you hope to gain from an INBRE Summer Research Fellowship? Write a statement about obstacles you have overcome to pursue your educational goals. Name and contact information of your mentor: Name: Email: Name and contact information of reference(s). Two references are required: either Mentor + one additional reference, or, if Mentor is not a reference, two additional references. Name: Email: If Mentor is not a reference: Name: Email: 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 February 7, 2014 Summer 2014 Undergraduate Fellowship Program Steps to submit the Fellows Application packet: 1. Be a student enrolled at an Idaho college or university who will be graduating with a Bachelor’s degree on or after December 2014. Students graduating in May or August 2014 will not be eligible in 2014. 2. Complete the Fellows application form. 3. Choose a mentor for a biomedical research project. Students may choose from the Faculty Mentors list on the website or from any faculty member active in biomedical science. 4. With the chosen mentor, prepare a Summer Research Plan describing the 10-week summer research project. 5. Assemble and submit the application packet. Packet must include an application form, a copy of the most current transcript (unofficial is acceptable), and the Summer Research Plan. 6. Request two confidential letters of reference. One of the may be your mentor. References must be submitted via the online form at inbre.uidaho.edu/references. References are due by the application deadline of February 7, 2014. 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 packet, letters of reference, by the due date of February 7, 2014. 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 2014 Summer Fellows program is contingent upon timely distribution of federal grant funds*** The Idaho INBRE (IDeA Network for Biomedical Research Excellence) Program is sponsored by NIH-NIGMS (National Institute of General Medical Sciences) Grant #P20 GM103408.