2015 Summer Undergraduate Research Program (SURP) Application

High School students may only apply to the "Travis B. Lewis Scholarship Award".

* Required field. The form will not submit if the required fields are not filled out.
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NAME AND ADDRESS:
First Name*     Last Name*
E-mail Address* (preferably NOT your email at school)
Phone Number* (include area code)
Current Address:
Street Address*
City*     State*     ZIP*

Home Address:
Street Address*
City*     State*     ZIP*

Foreign Address:
Street Address
City     Country        

Eligibility Requirements: Only U.S.citizens  or students with permanent resident status may apply.*
DOB* e.g. 09/19/1980  
Racial/Ethnic Background (optional) Gender (optional)
Additional information:  
Are you the first person in your family to attend college? Yes No

Do you come from a disadvantaged background? Yes No
Answer "Yes" if you come from an environment that has inhibited you from obtaining the knowledge, skill and abilities required to enroll in and graduate from a school; OR if you come from a family with an annual income below a level based on low-income thresholds according to family size published by the U.S. census.
If Yes, please elaborate:

School*
State/Country of School*
Major*
Cum GPA requirement: GPA> 3.25 required. Current GPA*
Undergraduate Class Level* Anticipated Graduation Date* (month/year)
Current career goals* If "other" please list

Do you speak fluently any language other than English? Yes No

What language(s)?


Deadlines:

  • Application Deadline for all programs is March 1, 2015.   
  • The deadline date for documentation of completion of all required immunizations for SURP 2015 program participants is May 1, 2015.
  • Please note: Hepatitis B vaccination requires a series of 3 doses that can take up to 7 months to complete. If accepted, you must have documented completion of 2 of the 3 vaccinations in the series by May 1, 2015, in order to participate in SURP 2015.
  • Submit the required application materials (i.e. transcripts, letters of recommendation, essays, etc.) to each department by the listed deadline date. Addresses and contact information can be found under 'Participating Departments'.
  • Note: If you applied to 3 departments, you will need to send required materials to each department's mailing address.
  • Do not send application materials to the Office of Recruitment and Student Engagement as doing so will delay the processing of your application.

You may apply to 3 SURP programs. If accepted, you must send a copy of required documents to each program selected.
High School students may only apply to the "Travis B. Lewis Scholarship Award".
Please rank in order of preference (use 1, 2, or 3). Requirements
Per Program
Deadline
 
Biochemistry/Molecular Biology March 1
Cellular and Integrative Physiology March 1
College of Nursing March 1
College of Public Health March 1
Eppley Institute for Research in Cancer
(Applicants must be US citizens or permanent residents to apply.)
March 1
Internal Medicine
(Applicants must be US citizens or permanent residents to apply.)
March 1
Internal Medicine Alcohol Research
(Applicants must be US citizens or permanent residents to apply.)
March 1
MD/PhD Summer Undergraduate Research Program
(Applicants must be US citizens or permanent residents to apply.)
March 1
Pathology/Microbiology March 1
Pediatrics
(Applicants must be US citizens or permanent residents to apply.)
March 1
Pharmaceutical Sciences March 1
Pharmacology and Experimental Neuroscience March 1
Radiation Oncology March 1
School of Allied Health Professions
March 1
Travis B. Lewis Scholarship Award   (For high school students only.) March 1

By requesting that my application be forwarded to these Departments, I acknowledge the time commitment of approximately 10 weeks / 40 hrs each week (or otherwise prescribed by the dept) if accepted to their program.

I understand that my acceptance, if offered a position, is contingent upon fulfilling the immunizations required by the University of Nebraska Medical Center. I agree to submit the requested immunization form by May 1, 2015.

Please note: Hepatitis B vaccination requires a series of 3 doses that can take up to 7 months to complete. If accepted, you must have documented completion of 2 of the 3 vaccinations in the series by May 1, 2015, in order to participate in SURP 2015.

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