Application Instructions for the Opportunities in Genomics Research: Extensive
Study Program at The Genome Institute at Washington University in St. Louis
Follow the instructions for completing the application for admission to the 2014 OGR
Extensive Study Program:
1.
Carefully complete all parts of the application including the Personal
Statements section. If any parts of the application are incomplete, your application will not be reviewed.
2.
A completed application includes:
An Application form
Three recommendation forms from STEM faculty
Official transcript(s)
Resume or CV
3.
To complete your application, send the following supplementary documents:

Official copies of your transcript(s) from the beginning of your undergraduate education through completion of your baccalaureate degree (include work from all institutions attended eg. two-year college). If you will graduate in Spring 2014, a transcript reflecting Fall 2013 will be accepted to review your application, but a complete transcript will be required prior to official admittance into the program.

Three faculty recommendation forms should be sent from your referees. Only recommendations from faculty at undergraduate institutions or higher will be considered. All three recommendations must be from a faculty in STEM (science, engineering, technology, mathematics). A voluntary, additional fourth reference , will be accepted from a non-STEM or nonfaculty member as a character reference (non-relatives only). To obtain a recommendation form or to submit a form, email us at: at outreach@genome.wustl.edu
. All submitted forms must originate from the email address of the referee.

An updated resume or CV detailing your education, work, research history, and honors/community service is required
ALL application materials and recommendations may be submitted electronically to
(preferred): outreach@genome.wustl.edu
Or via mail:
The Genome Institute
4444 Forest Park Blvd
Campus Box 8501
St. Louis, MO 63108
ATTN: Outreach Dept
(If mailing materials, use address exactly as printed above, otherwise receipt of materials will be delayed)
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** Note that your application is not complete until all supplementary materials have been received. See application instructions for more information.
Applicant Information:
Last Name First Name
Date of Birth
Current Address
Primary Phone (indicate: cell or home phone)
Primary E-mail Address
Permanent Address
Secondary Phone (indicate: cell or home phone)
Secondary E-mail Address
Middle Initial
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Do you have active accounts with any of the following social media?
__Facebook
__ Linked In
__Twitter
__MySpace
__ Other, indicate ____
Citizenship: (please check one)
U.S. Citizen
Background Information
Gender
__ Male
__ Female
__ Other (specify)_________
__ No Response
Ethnicity
Permanent Resident
__Hispanic, Latino or Spanish Origin (indicate below)
__NOT Hispanic, Latino or Spanish Origin
__No Response
If you selected Hispanic ethnicity (check all that apply below)
___ Mexican/Chicano
___Puerto Rican
___Dominican
___Cuban
___Other please indicate_____________
Racial Identification (check all that apply)
Black; please indicate (eg. African-American, Afro-Caribbean, etc.)
Asian; please indicate (eg. Chinese, Japanese, Vietnamese, etc)_______
___Asian Indian
Caucasian/White
Native American/American Indian; Tribe__________
Pacific Islander; please indicate (Samoan, Hawaiian, etc)__________
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___Other ____________________
No Response
Primary Language spoken ___________________
Secondary Language spoken__________________
Have you ever qualified for any of the following? (select all that apply)
__Federal Disadvantaged Assistance
__Scholarships for Individuals with Exceptional Financial need (eg. Pell Grant)
__Health Professional Student loans (HPSL)
__Loans for Disadvantaged Student Program
Are you first-generation college? ___ yes ___ no
Highest education level completed by parent(s) or guardian(s):
Father or Primary Guardian
___High school diploma/GED
___Associates
___Bachelors
___Masters
___PhD
___Professional degree (MD, JD, other); please indicate_____________
___No response
Mother or Secondary Guardian
___High school diploma/GED
___Associates
___Bachelors
___Masters
___PhD
___Professional degree (MD, JD, other); please indicate_____________
___No response
Primary Parents/guardian Occupation _____________________________
Secondary Parent/guardian Occupation ____________________________
Washington University School of Medicine will make reasonable accommodations for persons with learning or physical disabilities or persons that need special considerations for health related or religious reasons. Please indicate whether you need such accommodations or considerations.
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Yes______ No_______ If yes, provide a brief explanation here.
Educational Information
Have you earned a degree at any institutions? Yes___ no____
If yes, complete this section, Information on Degree Earned. If “no” skip to the Current
University Information section below
Information on Degree Earned
College/University of degree earned
Period of Attendance (mm/yyyy) to (mm/yyyy)
Date of Graduation (mm/yyyy)
Major
______________________________
Degree (eg. Bachelors of Science)
_______GPA (cumulative only)
_______ GPA in STEM (*see instructions-Calculating STEM GPA)
_______ Indicate the scale if other than 4.0
Current University Information
Are you currently enrolled at a college/university? Yes____ No_____
Current Class Standing (at time of application)
Sophomore Junior Freshman Senior
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Current College/University
Period of Attendance (mm/yyyy) to (mm/yyyy)
Anticipated Date of Graduation (mm/yyyy)
Major
______________________________
Anticipated Degree (eg. Bachelors of Science)
_______GPA (cumulative only)
_______ GPA in STEM (*see instructions-Calculating STEM GPA)
_______ Indicate the scale if other than 4.0
Previous Colleges/Universities Attended
Name of College/University
Period of Attendance (mm/yyyy) to (mm/yyyy)
Major
_______GPA (cumulative only)
_______ GPA in STEM (*see instructions-Calculating STEM GPA)
_______ Indicate the scale if other than 4.0
Indicate any STEM courses in which you are currently enrolled, but may not appear on your transcript.
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Other Background Information
Are you currently employed? Yes____ No_____
If yes, please complete “Employer Information”. Alternatively, you may write “see resume”, only if your resume contains the details below.
Employer Information
Name of Employer
Location (city, state)
Period of Employment (mm/yyyy) to (mm/yyyy)
Duties
How did you learn about the OGR program? (Check all that apply):
Instructor/Program Director, Name
Conference, Name
______Email
Brochure/Flier
Website
______Career Fair/Campus Visit, Where_______________________
______Word of mouth
______Former OGR student
Other, Please indicate
Future Interests
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Select all that apply to the indicated questions
__I plan to enter a graduate program
__I plan to enter a professional (eg. medical, dental etc.) program
__I have applied for admission to graduate programs
__I have applied for admission to professional programs
__I have interests other than graduate or professional school
Please indicate the graduate/professional degree program of interest:
PHD
MD/PHD
MD
______DDS
______Masters
______Other; please indicate_________________________________
Do you plan to take any of the following? (check all that apply)
GRE ______
MCAT_____
DAT_____
PCAT_____
LSAT_____
GMAT______
Other (indicate)________
Have you ever taken the GRE? _____ Yes ______No
If yes, the date you took the test (mm/yyyy)____________
What was your last score: Q____ V_____ Writing_____
Have you ever taken the MCAT ____Yes ____No
If yes, the date you took the test (mm/yyyy)___________
If yes, what were your last scores?
____Bio Sci _____Phys Sci _____Verb Reas _____Writing
Research Experience/Skills
Have you participated in any research excluding course work (eg. summer or academic year internships).
___ No
___ Yes (please list the details of each internship in the grid below.)
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Please list the details of your research experience here.
Year Name of Program Institution Name of
PI/email address
Research Area Length of Internship
(mm/yyyy to mm/yyyy)
Have you or do you currently participate in any of the following programs
__OGR
__MARC-USTAR
__MBRS- RISE
__IMSD
__LSAMP
__AMGEN
__Leadership Alliance
__NSF-REU
__SURF
__SMDEP
__Others (indicate full name of program and institution of participation)
Please indicate whether you have been involved in any of the activities during your undergraduate matriculation a.
Attended a conference or societal meeting for students majoring in the biomedical sciences (e.g.,
ABRCMS, SACNAS)
No Yes b.
Presented a poster at a biomedical conference or societal meeting
No Yes c.
Participated in sessions focused on graduate school planning and preparation for the biomedical fields d.
No Yes e.
Participated in a business or industry related internship related to a biomedical field
No Yes f.
Served as a mentor/tutor to other undergraduates majoring in biomedical areas
No Yes g.
Co-authored a biomedical research publication (for a peer reviewed journal)
No Yes h.
Participated in a GRE/MCAT preparation course or workshop
No Yes i.
Prepared a science abstract for your research project
No Yes
Please indicate if you have experience in the following: a.
Interpreting data
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No Yes b.
Organizing data
No Yes c.
Working with other science professionals in a group
No Yes d.
Working independently in a science research lab
No Yes e.
Communicating your research findings orally with professionals in the scientific research community
No Yes f.
Communicating your research findings in writing to other professionals in the scientific research community
No Yes g.
Reading and interpreting scientific literature
No Yes h.
Analyzing a problem and formulating a solution
No Yes i.
Writing a scientific research abstract
No Yes j.
Preparing a scientific research poster
No Yes k.
Facilitating a Q&A session related to you scientific research poster
No Yes
Please indicate if you have experience in the following: a.
Reagent preparation (e.g., solutions)
No Yes b.
Micropipetting
No Yes c.
Preparing gels (agarose or polyacrylamide) or gel electrophoresis
No Yes d.
Streaking/plating bacteria
No Yes e.
Analytical evaluation of DNA or protein (e.g. interpreting gels, spectrophotometry)
No Yes f.
DNA restriction enzyme analysis/ligation/cloning
No Yes g.
DNA transfection and/or Plasmid isolation
No Yes h.
Bacterial culture
No Yes i.
Polymerase Chain Reaction (PCR) of DNA
No Yes j.
RT-PCR or real-time PCR of RNA
No Yes k.
Chromatography (size exclusion, ion exchange)
No Yes l.
High Performance Liquid Chromatography (HPLC)
No Yes m.
Cell or tissue cultures
No Yes n.
Storing or thawing cell lines
No Yes o.
Antibiotic selection of cells or colonies
No Yes
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p.
Computer search of nucleotide or protein sequences (BLAST)
No Yes q.
Advanced Bioinformatics tools (e.g., protein structure, comparative genomic analysis, ENTREZ, Santa
Cruz)
No Yes r.
Chromatin immunoprecipitation
No Yes s.
Microarrays (sample preparation or analysis)
No Yes t.
DNA or protein sequencing
No Yes u.
Epigenetic analysis (DNA methylation, histones)
No Yes v.
Blotting Methods (Southern, Northern, Western)
No Yes
Indicate which _____________________________________________________ w.
Comparative genetics (e.g., mouse)
No Yes x.
In vivo work (animal or plant experiments)
No Yes y.
Molecular medicine (study of diseased patients or tissues)
No Yes z.
Human variation (sequence or epigenetic comparison of individuals)
No Yes aa.
Synthetic Techniques
No Yes bb.
Spectrophotometric Techniques (UV-VIS, FTIR, Luminescence, NMR)
No Yes cc.
Assay techniques
No Yes dd.
Chromatographic Techniques (LC, GC, tandem MS)
No Yes ee.
Electroanalytical Techniques
No Yes ff.
Environmental Sampling Techniques
No Yes
Please list any additional research techniques you have been taught and/or competently performed in the lab that are not listed above. Alternatively, you may write “see resume”, only if your resume contains such details.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Honors/Achievements
Please list any academic awards/honors received during your undergraduate matriculation. Write N/A if not applicable. Alternatively, you may write “see resume”, only if your resume contains the details of the table below.
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Name of Award/Honor
(eg., Dean’s List)
Year(s) Award received
(eg. 2007-2008)
List any STEM-related organizations, honor societies, or programs, in which you have participated during your undergraduate matriculation. Alternatively, you may write “see resume”, only if your resume contains the details of the table below.
Name of
Organization (eg.
Beta Kappa Chi,
Biology Club, etc)
Year(s) Involved Duration months)
(eg. 3 Offices held
List any substantial involvement in community activities. (note: you can list organizations you belong to at your school as well as external organizations, as long as it provides a service to the university or the outside community. Examples include, you volunteer at a hospital once a week, etc.) Alternatively, you may write “see resume”, only if your resume contains the details of the table below.
Name of Organization Your duties or primary activities of the group
Year(s) Involved and
Frequency
2008/once/month)
(eg.
Personal Statement Section
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Please write short statements to answer the six questions below. These statements should be brief, but should be answered completely. Include an additional sheet if necessary.
Who or what has influenced your potential career choice?
What are your current research or science interests and why?
Why do you want to pursue a career in science, technology, engineering or mathematics?
What steps have you taken to pursue your career of interest?
Why do you want to participate in the OGR program?
Please describe any circumstances that may have prevented you from pursuing a graduate degree upon graduation.
Attachments
1) Please attach any published abstracts from previous research (include title, author list with institutional affiliations, and name of publication or meeting where abstract appears or was presented). This includes abstracts presented at national or regional meetings.
Indicate in this space if an attachment is included.
2) Attach references to any publications where you are the author or co-author. Please follow MLA format. (include: author list, title of article, name of journal where article appears, year, etc). Indicate in this space if an attachment is included.
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References
Please list the names of three faculty members who will provide recommendations on your behalf. All three references must be from STEM faculty. An additional, fourth reference from non-STEM or non-faculty is allowed and encouraged. This reference should be based on your character. The reference forms received from referees must match the names below. The forms received must match the names below. If you use a different referee you must notify us in writing .
Name Title/Department Email address/contact phone number
Student’s Signature (digital or electronic acceptable)
Date
ATTN Applicant: Before submitting your application, please convert to PDF
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Instructions for Calculating STEM GPA
OGR: Undergraduate Scholars Program
This list is designed to give you examples of the types courses to include in the calculations of your STEM GPA.
In your calculations:
-You should include all the STEM courses that count toward your major, with some exceptions (see below)
-Please exclude STEM courses that are required by the general student body
Examples of courses to include:
General courses for STEM majors such as:
Biology, Chemistry, Physics, etc
Biology courses such as:
Genetics
Molecular or Cell Biology
Ecology/Environmental Biology
Botany/Plant Sciences
Physiology
Science Seminar
Research Ethics
Biotechnology
Others
Chemistry courses such as:
Organic Chemistry
Physical Chemistry
Biochemistry
Others
Math courses such as:
Calculus I and higher
Statistics
Other advanced courses
Others:
Various Engineering, Computer science, and Physics courses for majors
Do not include :
Allied health/nursing courses
Algebra, precalculus, etc.
Social sciences/Psychology courses
If you have any questions please contact our office at outreach@genome.wustl.edu
or
314-286-1803 or 1897
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