Please make sure you have your unofficial transcript and the names of two faculty who can provide a recommendation before completing this form. 2023 Application Applicant Information * First Name * Middle Name * Last Name * Date of Birth (mm/dd/yyyy) * Race American Indian or Alaska Native Asian Black or African American Native Hawaiian and other Pacific Islander White Other Prefer not to say * Ethnicity Hispanic or Latino Not Hispanic or Latino Prefer not to say * Disability Please Select Yes No Prefer not to say The SPARC program seeks to increase participation by individuals from underrepresented groups (see NIH Notice of Interest in Diversity, NOT-OD-20-031, for additional details * Disadvantaged Please Select Yes No Prefer not to say If Yes, please list all of the following that apply: 1) eligible for Federal Pell grant, 2) first in family to complete a bachelor's degree, 3) homeless, 4) in the foster care system, 5) eligible for SNAP/Federal fee and reduced lunch, 6) grew up in qualifying zip codes The goal of this program is to enhance training and increase diversity in the biomedical workforce in cancer research. Please comment on how your participation will enhance diversity of the biomedical workforce. * Gender Please Select Male Female Prefer not to say This program is only available to US citizens and permanent residents * Citizenship Please Select U.S. Citizen or Permanent resident Not U.S. Citizen or Permanent resident Permanent Mailing Address * Street Address Street Address Line 2 * City * State Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Not Applicable * Zip code * Email Address * Cell Phone Number Academic Information * Undergraduate Institution * Current Academic Year Please Select Freshman Sophomore Junior Senior * Expected Graduation Date (mm/dd/yyyy) * Major * Undergraduate GPA Faculty Recommendations Please provide the names and email addresses for two faculty members who can provide a recommendation for you. They will be contacted for their recommendation once you submit this application. References with a ".edu" email address are preferred. * Name * Email * Name * Email Personal Statements Please enter your responses to the following questions, keeping each response to 250 words or fewer: * 1. Please tell us why you are applying to our program: * 2. Please describe any current or previous research experience: * 3. Please tell us how you spent last summer: * 4. Please describe your interest in research and choose up to three potential mentors in the GW-SPARC program. Please see potential mentors here. * 5. What are your plans after graduation? * 6. Do you have any travel plans or obligations that will conflict with the May 28 - August 5 program dates? Please describe. Unofficial Transcripts *Please upload unofficial transcripts from your undergraduate institution.
