HARVARD SUMMER RESEARCH PROGRAM IN KIDNEY MEDICINE APPLICATION 2018
Please complete the online application and email your supporting documents by December 31st, 2017.
APPLICATION INSTRUCTIONS
Thank you for taking the time to complete this application.
Please be advised that incomplete applications will not be saved. Once you start the online portion you must complete application. Remember to select submit upon completion.

In your personal statement please describe in 400-750 words your educational and professional goals and how your participation in the Harvard Summer Research Program in Kidney Medicine will assist in meeting your goals. Be sure to articulate your qualifications and your reasons for wishing to participating in this program. Please include a header on all pages with your last name. Please send a PDF of your personal statement and your supporting documents to our inbox HSKP@partners.org

Supporting Materials

- Copy of your government issued ID, acceptable IDs include your state ID, driver's license or passport

- Resume

- Choose 2 professional or academic recommendation writers and have them email their letters on your behalf to HSKP@partners.org by December 31, 2017. The letters must be signed and on official letterhead.

- All transcripts must be official. Please submit one official transcript from your current institution; however if you are a transfer student that has been at your current institution less than one year, please submit a transcript from your prior institution.
NOTE: If your institution does not send e-transcripts you may mail your official transcript to the attention of:

Shekora Saint, MHA
Education Program Manager
75 Francis Street, MRB4
Boston, MA 02115

Questions: HSKP@partners.org

Applicant Full Name
Your answer
Gender
Area of Interest:
Your answer
Email
Your answer
Current Degree Goal
Your answer
Applicant must be a US Resident or Permanent Resident
(Please check box below)
Are you enrolled in an undergraduate degree granting program?
Please check one option below
Applicants must be available to commit to the entire eight weeks of the program
Are you available June 1st through August 6th?
Required
RACE/ETHNICITY/DISABILITY/DISADVANTAGED BACKGROUND
Responses to these items will help provide statistical information on the participation of individuals from diverse groups in Public Health Service (PHS) programs and identify inequities in terms of recruitment and retention based on race, ethnicity, disability and/or disadvantaged background. Participants are strongly encouraged to provide this information; however declining to do so will in no way affect their appointments. This information will be retained by the PHS in accordance with and protected by the Privacy Act of 1974. Racial /ethnic/ disability /background data are confidential and all analyses utilizing the data will report aggregate statistical findings only and will not identify individuals.
Ethnic Background
Racial Background
DISABILITY: A person or mental impairment that substantially limits one or more major life activities
Do you have a disability?
Required
If yes, which of the following categories which describes your disability (ies):
DISADVANTAGE BACKGROUND: An individual is considered to be from a disadvantaged background if he or she:
1. Comes from a family with an annual income below establish low-income thresholds, published by the U.S. Bureau of the Census; adjusted annually for changes in the Consumer Price Index; and adjusted by the Secretary for use in all health professions programs. The Secretary periodically publishes these income levels at http://aspe.hh.gov/poverty/index.shtml. Individuals falling in this category must have qualified for Federal disadvantaged assistance or have received Health Professional Student loans (HPSL), Loans for Disadvantaged Student Program, or scholarships from the U.S. Department of Health and Human Services under the Scholarship for individuals with Exceptional Financial Need.

2.Comes from a social, cultural, or educational environment, such as that found in certain rural or inner-city environments, that has demonstrably and recently directly inhibited the acquisition of the knowledge, skills and abilities necessary to develop and participate in a research career. This category is most applicable to high school and perhaps undergraduate students, but more difficult to justify for individuals beyond that level of achievement.

Are your from a disadvantaged background?
Person to Notify in Case of Emergency
Name
Your answer
Emergency Contact Street Address
Your answer
Emergency Contact Phone Number
Your answer
Education
Current School Name
Your answer
School Street Address
Your answer
Academic Major
Your answer
Academic Advisor
Your answer
Current Cumulative GPA
Your answer
Expected Graduation Date
Your answer
Current Academic Year
Please state if you are currently a first year student (Freshman), second year student, etc...
Your answer
Personal Achievement
Please list any personal honors or awards you received below
Your answer
Please list the Institution/Organization that gave you the award
Your answer
Please give the date or year the award was received
Your answer
Personal Achievement
Please list any personal honors or awards you received below
Your answer
Please list the Institution/Organization that gave you the award
Your answer
Please give the date or year the award was received
Your answer
Personal Achievement
Please list any personal honors or awards you received below
Your answer
Please list the Institution/Organization that gave you the award
Your answer
Please give the date or year the award was received
Your answer
Research Related Work History
Please list your position title during your research history
Your answer
Please list the institution or organization where you completed your research
Your answer
Please list the date(s) or year(s) you worked on your research
Your answer
Please list the duties your performed during your research
Your answer
Research Related Work History
Please list your position title during your research history
Your answer
Please list the institution or organization where you completed your research
Your answer
Please list the date(s) or year(s) you worked on your research
Your answer
Please list the duties your performed during your research
Your answer
Research Related Work History
Please list your position title during your research history
Your answer
Please list the institution or organization where you completed your research
Your answer
Please list the date(s) or year(s) you worked on your research
Your answer
Please list the duties your performed during your research
Your answer
How did you learn about this program
Please check the box below which indicates how you learned about this program
Required
Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made on this application may result in my immediate dismissal.
Full Name
Your answer
Date
Your answer
Our Policy
It is the policy of this organization to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age or disability.

Thank you for completing this application form and for your interest in participating in our program.

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