Application Form for Philips Institute Summer Research Program

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Please complete all fields and email your resume, personal statement and unofficial transcripts top sodresearch@vcu.edu

Email *

Last Name *

First Name *

Preferred email *

Are you a US citizen? *

Yes

Are you a permanent resident of the US?
*

Yes

What academic year will you be during the summer school? *

Rising Sophomore

Rising Junior

Rising Senior

Other:

What University do you attend? *

What is your current GPA? *

What is your declared major? *

Do you have prior research experience in a biomedical laboratory (excluding lab courses for credit)?
*

Yes

Upon graduation what program do you plan to apply to
*

PhD

Dentistry

Medicine

Pharmacy

Other:

List the names and email addresses of your referees
*

In order of preference please list three Philips Institute Faculty members you would like to work with
*

Where did you hear about the summer school? *

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