HWI Structural Biology Workshop Scholarship Application Form

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Hauptman-Woodward Medical Research Institute offers educational programs that promote the development of a diverse and well-prepared local workforce. To support our mission, we have created a scholarship program that will provide financial support and reduce barriers to entry, not only to our programs, but also to scientific careers. Please fill in the form below to be considered for a scholarship. This scholarship will cover the registration fees associated with the workshop.

Personal Information

All answers will be kept confidential

Full Name *

Email Address *

What is your Citizenship? *

Must be a US citizen, US National or Permanent Resident in order to apply

US Citizen

US National

Permanent Resident of US

Other:

Gender *

Female

Male

Decline to answer

Ethnicity *

Asian

Black/African American

Hispanic/Latino

Pacific Islander

White/Caucasian

Decline to answer

Other:

University Affiliations

Current University *

Must be enrolled at a partner institution

What is your current student status? *

Enrolled as an undergraduate (BS or BA)

Enrolled in a Graduate Program (PhD)

Enrolled in a Masters Program (MS)

Other:

Name of University Department *

What is your current major or thesis project title? *

What are your long term career goals? *

Research Experience

Prior research experience is not required for awards.

Which of the following have you participated in? Check all that apply. *

Summer Research Internship

Academic Year Undergraduate Research

Graduate Level Research

HWI workshops or events

Other:

Required

Please write a brief description of your need for this scholarship and the impact it will have. *

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