Columbia University
Department of Biological Sciences

Summer Undergraduate Research Fellowship (SURF) 2015
Online Application
First Name: Last Name:

Date of Birth:
(mm-dd-yyyy)

Email:
(Note to Barnard students: Please
regularly check your Columbia email)

Alternative Email (non .edu):
(Required)

Campus phone #:
Campus Street Address:
Campus City:
Campus State:
Campus Zip code:
Permanent phone # :
Permanent Street Address Line 1:
Permanent Street Address Line 2 (optional):
Permanent City:
Permanent State:
Permanent Zip code:
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:

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:

(Graduating seniors are not eligible for SURF)



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

Cumulative GPA (on a 4.0 scale; Use #.## format)

Advanced Degree Objective:

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

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

 

Are you currently receiving any of these within the dropdown box?
In which school at Columbia are you registered?
Your major (declared or expected)

Some labs have projects that will last just for the summer, others are looking for students who would want to continue working during the fall semester. To help us with lab placements, please indicate whether you would like to work

only in the summer summer and fall unsure at this point


Please do not cut-and-paste essays that you've written for other purposes. Just write a brief response to the questions below!

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 with spaces, or about 75 words)

Describe what you would like to be doing at work in 20 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 with spaces, or 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 SURF 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

Please copy and paste below your transcript from SSOL, which you can access from "Grades and Registration Status" on the SSOL website (ssol.columbia.edu). (If you attend Barnard, paste your eBear transcript). Do not edit or format it (with HTML tags or anything like that) because our program does it automatically. If you are a first-year, you may list high school AP courses at the very bottom.



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

Please state the following if you are already in a certain biology-related lab at Columbia University:

  1. PI name
  2. In what capacity? (work study, volunteer, c3500, technician, etc.)
  3. Paid?
  4. Length of time in lab?
Previous experience does not guarantee you a spot in SURF. Please have your mentor contact us, if you are interested in performing research in your present lab.
(Limit 450 characters with spaces or about 50 words)

Agreement

By submitting this form, you agree that, if selected for a SURF fellowship, you will:

Submission of this form also authorizes the SURF program to obtain an official transcript from the University Registrar and distribute it to potential mentors.

I have read and agree to these conditions:

Submit Your Application

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