Columbia University
Department of Biological Sciences

Amgen Scholars Summer Research Program 2014
Online Application
Last Name: First Name:

Date of Birth:
(mm-dd-yyyy)

Email:

Alternative Email (non .edu):
(Required)

Phone # :
Home Address 1:
Home Address 2:
School Address 1:
School Address 2:
Home State: If you graduated high school in the US, which state did you graduate in
Gender:

Ethnicity:

(Please check all that apply)

American Indian / Alaskan Native
African-American / Black
Pacific Islander
Mexican American / Chicano / Latino
Asian American
Middle Eastern
White / Caucasian
Other:
Decline to State

Citizenship Status:
(Please note that non-U.S. citizens and non-permanent residents are not eligible to apply.)

U.S. Citizen
Permanent Resident, Place of Birth
Other

Parents Educational Background:

Mother, Highest Degree Earned:

Father, Highest Degree Earned:







Class completed at the end of the coming spring quarter/semester:

(Please note that only second year, third year, and non-graduating fourth year undergraduates are eligible to apply)



What month and year do you anticipate to graduate with your bachelors degree?

Cumulative GPA:
(on a 4.0 scale; you must have a cumulative GPA > 3.2 to apply. Use #.## format)

Advanced Degree Objective:

Ph. D.
M. D./Ph. D.
M. A./M. S.
M.D.
Other, Please Specify:

Does your four-year college or university offer an undergraduate research program?

Yes
No

How did you hear about the Amgen Scholars program?

Amgen National Website
University website, University name:

E-mail Announcement
Poster
Conference, Conference name:

Academic Advisor
Internet Search
Faculty/Staff from home university
Faculty/Staff from other university
University name:

Other, please specify:

Are you applying to any other Amgen Scholars sites?

No
Yes (if yes, where? )

Have you participated as an Amgen Scholar in the past?

No
Yes

(note that if you have participated IN THE AMGEN SCHOLARS PROGRAM AT ANY OF THE TEN UNIVERSITIES that you are NOT ELIGIBLE to participate again)


Did you perform original research before this summer where you had your own project?

Yes
No

Can you arrive at CU for the first day of the program, which is the day after Memorial Day each year?

Yes
No
Comments:

Currently attending which College/University:


You must be attending a four-year college or university in the United States, Puerto Rico, or other US territory. If your school is not listed, please email surf@biology.columbia.edu and we will add it immediately.

Your major (declared or expected)
Date Spring semester ends:


Laboratory or science-related experience
Have you participated in research as an UNDERGRADUATE (either during the academic year or the summer)? If yes, please explain the project and list the dates of participation, and please include the name of the principal investigator and the affiliation of the lab (Limit: 700 characters with spaces, or about 100 words).

Career Plans
Write a short description of your future career plans. (Limit: 500 characters, about 75 words.)

Describe what you would like to be doing at work in 10 years, if you could have your ideal job. Specify 2 or 3 example tasks that you would perform during a normal work day.
(Limit: 500 characters, about 75 words.)

Please pick five mentors whose research you are interested in. List them in order of preference with the first being the laboratory you would most like to spend time in. A description of their research projects is listed under the Mentors section of the Amgen webpage.

1

2

3

4

5

Science Courses

Enter the titles, credit values, and grades you recieved in all science courses you have taken. Include courses taken in biology, neuroscience, mathematics, computer science, engineering, and physics, but LIST ONLY COURSES MEANT SPECIFICALLY FOR SCIENCE MAJORS.

Title Credits Grade


Transcript

Arrange to have an official transcript mailed to:

Dr. Alice Heicklen
744B Mudd Bldg., MC2454
Columbia University
1212 Amsterdam Ave.
New York, NY 10027

References
List names and email address of the people whom you have asked to write you letters of recommendation. Instructions on how to provide a recommendation will be emailed directly to them, so be sure to verify the email addresses you provide!

Name: Email:

Name: Email:

I waive my right to review these letters of recommendation : Yes No

Agreement

By submitting this form, you agree that, if selected for an AMGEN fellowship, you will:

  • Participate in the 10-week program of full-time laboratory research
  • Check the email you applied to the program with regularly
  • Not attend classes, or hold another job or volunteer position during the term of the Program
  • Present your research during a weekly meeting
  • Participate in the seminar on scientific communication skills
  • Submit a research article of your findings as an electronic file in pdf, signed by principal investigator
  • Attend the Amgen Scholars Symposium in California, the third weekend in July
  • Notify us of any published articles on which your name appears
  • Are a U.S. citizen with documented proof of citizenship
  • Live in housing provided by the Columbia University Amgen Scholars Program
  • Adhere to the Amgen Scholars Program/Columbia University Code of Conduct
  • Complete all surveys related to the Amgen Scholars Program, both during and following completion of the program
  • Inform us of any graduate school program you are accepted into
  • Have not previously participated in the Amgen Scholars Program
  • Report any additional fellowships or sources of funding for the summer
  • Discuss lab results during weekly lab meeting at least once during the summer

I have read and agree to these conditions:

Submit Your Application

Hit the Submit button, and wait a minute for it to send.