Furman Oncology Research Team (FORT)
2009 Summer Research Application
Application Deadline: Monday, April 13, 2009
Name: Age:
Home Address:
Campus Address:
Email address: Telephone number:
Graduation Year: Major:
Have you previously participated in a research project or experience?
Where and with whom?
When and for how long?
Describe the research topic(s)?
List the laboratory techniques you have mastered (tissue prep, electrophoresis, PCR, etc).
1. What is (are) your reason(s) for applying for this position?
2. What do you expect to learn from this experience?
3. What are your long-term professional goals (i.e., graduate school, medical school etc.)
4. Is there anything else you would like us to know about yourself and/or your science background? Please feel free to include hobbies and other interests.
Have you received the following training and if so, when?
HIPAA training?
Citi Training (training for working with Human subjects)?
Please attach an “unofficial” copy of your transcript including grades and GPA. An "official transcript" is NOT required. (Note: This can be found in VIP under “Academics” and “Record of Academic Work for Advisement Only - All.” Copy and paste this listing with GPA to the end of this application.)
References: Please provide the name, email address, and telephone number of three medical professionals and/or USC faculty members who know you well enough to comment on your suitability for this program.
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Signed: Date:
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