Physician Scientist Development Office

INSTRUCTIONS:

To complete this online application you will need to have the following ready to upload since it is not possible to save your application and come back to complete it later.

Complete ALL sections of this application – It is your responsibility to make certain that your transcript(s), one-page essay (Arial 11, 1-inch margins), and recommendation letters are received by the date listed above. Incomplete applications will not be reviewed.
Transcripts – Official sealed transcripts are not required.
Letters of Recommendation – Request recommendation letters from two people familiar with your academic Each recommendation letter should be in a separate envelope and signed on the back across the sealed flap by the person making the recommendation, OR it may be emailed directly to Ms. Suzanne Byan-Parker (sbyanparker@uabmc.edu)

All applications must be received by Monday, April 24, 2023, by 5pm (CST).

Eligibility Requirements:

We are accepting applications for these paid internships from undergraduate or graduate students currently enrolled in masters programs from historically black colleges/universities (HBCUs), minority-serving institutions (MSIs), and UAB. Students will receive a stipend for at least 30 hours per week.

First Name (*)

Please enter your first name.

Middle Name(*)

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Last Name(*)

Please enter your last name.

Current Street Address(*)

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Current City(*)

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Current State(*)

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Current Zip Code(*)

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Current Email Address(*)

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i.e. Current Email (School Email)

Permanent Email(*)

Telephone (Cellphone)(*)

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Demographics

Please complete this section accordingly.

Are you a U.S. Citizen? (*)

US Citizen

Permanent Resident

Other

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If other, please specifiy:

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Racial Category(*)

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If Other, please specify

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Ethnic Category(*)

Hispanic or Latino

Not Hispanic or Latino

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Date of Birth(*)

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Gender(*)

Male

Female

Other

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Do you have a driver's license(*)

Yes

No

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Will you have use of a car if public transportation is not available?(*)

Yes

No

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Do you have any special needs to be considered? (*)

Yes

No

Prefer not to answer

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If yes, please specify

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Emergency Contact Information:

Please list the name or names of people to be notified in case of an emergency.

Emergency Contact Name (Full Name)(*)

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Emergency Contact Relationship(*)

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Emergency Contact Email Address(*)

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Emergency Contact (Cell Phone)(*)

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Emergency Contact Home Phone(*)

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Emergency Contact Address(*)

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Please enter full address.

Recommender Information:

Please enter the full name, position, and email address of both recommenders below.

Recommender #1 Name(*)

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Recommender #1 Position(*)

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Recommender #1 Email Address(*)

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(Please type in, do not copy and paste)

Recommender #2 Name(*)

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Recommender #2 Position(*)

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Recommender #2 Email Address (*)

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(please type, do not copy and paste)

Educational Background Information

Current Institution(*)

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Graduation Date(*)

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Undergraduates: Please list expected graduation date

Major(*)

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Please enter your major(s)

Minor

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Please enter your minor (If applicable).

Academic Classification

Undergraduate

Graduate

Other

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In March 2023, which will you be?(*)

GPA(*)

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Please list your most recent science courses here.

Science Courses(*)

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Honors, Scholarships, Achievements, and Awards

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Please list your Honors, Scholarships, Awards, and other Achievements.

Extra Curricular Activities

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Please list your extra canicular activities, both college and professional.

Community Activities

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Please list any relevant community activities.

Abilities and Skills

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Please list your abilities and skills. (i.e. computers, laboratory techniques, etc.)

Area of Research Interest

Indicate your 1^st, 2^nd, and 3^rd choice(s) regarding the type(s) of a research project, the research program area(s), and the type(s) of cancer which interest you. Select your 1st, 2nd, or 3rd choice of "Catergory of Interest", "Research Program Area", and "Type of Cancer" from the dropdown menus below.

Category of Project 1 (*)

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Category of Project 2(*)

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Category of Project 3

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Please specify

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Research Program Area 1

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Research Program Area 2

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Research Program Area 3

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Please specify

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Type of Cancer 1

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Type of Cancer 2

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Type of Cancer 3

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Do you have a specific mentor in mind? (*)

Yes

No

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If yes, please include their full name, contact information, and brief description of project..

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Availability for Assignment

Student trainees are expected to work for the entire 8-week training period:

Wednesday May 31, through Wednesday July 26

Your schedule will include approximately 20 hours a week of required course work and time to work with your mentor to develop a research project. This schedule will be determined with your mentor during the first week of training.

Tentative PRSTP course dates are:

Weekly -- Research seminars (dates TBA)
Cancer Education at UAB (dates TBA)
Cancer Research Symposium hosted by TU (Tues-Wed, July 25-26, 2023)

Recruitment Information

Have you ever participated in a Summer Training/Enrichment Program in the past?(*)

Yes

No

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If yes, please indicate where

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How did you learn about the UAB Partnership Research Summer Training Program?(*)

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Statement of Intent Essay

Please submit a one-page essay (250 words) attached to this document. It must be typed (Arial 11 with 1-inch margins). Your writing will be evaluated for clarity, grammar, spelling, and coherence. The essay should address the following:

Why would you like to participate in the UAB Partnership Research Summer Training Program (PRSTP)?
How does this training program relate to your academic and career goals?
What qualifications distinguish you from other potential applicants?

The UAB Partnership Research Summer Training Program will review applications. Final selections will be made
by Friday, May 5, 2023.

Please upload your Statement of Intent(*)

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Word Document and PDF format only.

Please upload your CV/Resume(*)

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Checking this box certifies that the information submitted in this application is true and correct to the best of my knowledge. I give the UAB PRSTP permission to share this information for recruitment and placement. If selected, I authorize and release UAB to videotape, photograph or otherwise record my participation in this program.(*)

Yes

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Please convince the system that you are not a robot.(*)

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Cancer Partnership Research Summer Training Program

Demographics

Emergency Contact Information:

Recommender Information:

Educational Background Information

Area of Research Interest

Availability for Assignment

Recruitment Information

Statement of Intent Essay