OSU HHMI Med into Grad Fellowship Application / 2015-2016

The Ohio State University and Howard Hughes Medical Institute

Med into Grad Scholars Program

2015-2016 Fellowship Application

Personal Information
LAST NAME: / FIRST NAME:
OSU EMAIL: / PHONE:
OSU ID: / GENDER: / Female Male

Educational Information

GRADUATE PROGRAM:
RESEARCH ADVISOR:
RESEARCH ADVISOR DEPT:
GRADUATE GPA:
UNDERGRADUATE INSTITUTION:
UNDERGRADUATE MAJOR:
UNDERGRADUATE GPA:
MA/MS: / MA MS N/A
MASTERS GPA:

Test Scores

GRE ATTEMPTS: / GRE SCORE:
GRE-QUANTITATIVE: / GRE-VERBAL:
GRE-ANALYTICAL:

Area of Research

Biomedical Engineering / Computational Biology / Genetics
Infectious Diseases / Neuroscience / RNA Biology

Research Proposal (not to exceed two pages)

Title:
AREA OF RESEARCH:
Hypothesis:
Specific Aims:
Research Plan:
Background & Significance
Preliminary Data:(optional)
Experimental Plan:
Summary:

Personal Statement (not to exceed one page)

Briefly outline your career aspirations and motivation for applying to the OSU HHMI MED into GRAD Scholars Program. Describe program expectations and interest in particular didactics or clinical experiences. Please limit response to no more than 1 page.

Applicant Biographical Sketch (not to exceed four pages)

NAME OF FELLOWSHIP APPLICANT / POSITION TITLE
Email address:
EDUCATION/TRAINING (Begin with baccalaureate or other initial professional education, such as nursing, and include postdoctoral training.)
INSTITUTION AND LOCATION / DEGREE
(if applicable) / YEAR(s) / FIELD OF STUDY

A. Positions and Honors

ACTIVITY/OCCUPATION / BEGINNING
DATE (mm/yy) / ENDING
DATE (mm/yy) / FIELD / INSTITUTION/COMPANY / SUPERVISOR/
EMPLOYER

B. Academic and Professional Honors

C. Publications

D. Scholastic Performance

SCIENCE / OTHER
YEAR / COURSE TITLE / GRADE / YEAR / COURSE TITLE / GRADE

Additional Materials Checklist (submit with application)

Applicant’s biographical sketch (sample posted on web)

Research advisor’s NIH biographical sketch or CV (4 page limit)

Letter of support from research advisor addressing the scientific potential and training plan of the applicant

Letter of support from any additional research mentor (optional)

Program Director Evaluation* (found on the web): medicine.osu.edu/go/hhmi

*If student waives his/her right to view the completed evaluation, Program Director should email directly to

APPLICATION DEADLINE: 5:00 PM April 17, 2015

All application materials should be emailed to:

medicine.osu.edu/go/hhmi

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