Undergraduate Summer Research Application

The Department of Chemistry at the University of Pittsburgh is pleased to announce five SURF (summer undergraduate research fellowship) positions open to underrepresented minorities in the STEM disciplines and/or female applicants.

The applicant must be a chemistry or closely related major; a US citizen or permanent resident; and have an expected graduation date in 2019.

The program runs from May 29th through August 3rd, 2018. The stipend awarded will be $371.00 per week for 10 weeks.

Applicants are required to attach their cover letter, official or unofficial transcript, and select four research groups in which they are interested.

The application review process begins on February 1st and continues until the five positions are filled.
Name * First Last
Email *
Phone Number * ### - ### - ####
Date of Birth MM / DD / YYYY
Current Mailing Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Demographic Information

The demographic information collected is designed to provide the department with ethnic and gender data on all applicants.
Gender *
Male Female
Are you of Hispanic or Latino ethnicity?
*
Yes No

(meaning a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race)
Please select one or more race(s)/ethnicity(ies) from the following groups that you identify with: *
American Indian or Alaskan Native Native Hawaiian or Other Pacific Islander Asian White Black or African American
Citizenship Status *
Citizen of *

Fill in country of citizenship
Optional Practical Training (OPT) authorization obtained? *
Yes No

Fill in country of citizenship
Academic Information
Name of institution you currently attend
Major
Expected Date of Graduation MM / DD / YYYY
What is your current plan for post-graduation?
College or university honors, such as scholarships, fellowships, honor societies, etc.
Presentations and Publications

For Publications: Please include full title, place, year and page numbers

For Presentations: Please include presentations given at your home or other instutions
Cover Letter *
Official or Unofficial Transcript *
Research Group Interest

Please indicate your top 4 preferences for research groups:
First Choice *
Second Choice *
Third Choice *
Fourth Choice *
References

Please direct your references to the following link to upload Letters of Recommendation:
https://pitt.wufoo.com/forms/undergraduate-research-reference-form/
Name of Refernce #1 First Last
Email of Reference #1
Name of Reference #2 First Last
Email of Reference #2
Under provisions of the Family Educational Rights and Privacy act of 1974 (P.L.93-380), students have the
right to examine the contents of their files, including letters of recommendation. However, applicants may
waive their right to see letters of recommendation, whereupon such letters will be held in confidence. If an
applicant does not waive his/her right to examine a letter of recommendation or if the applicant does not
sign the waiver, the letter of recommendation is considered accessible to the applicant.
Select a Choice *
I waive my right to examine the attached letter of recommendation. I DO NOT waive my right to examine the attached letter of recommendation.
Do Not Fill This Out

Wufoo

Demographic Information

Academic Information

Research Group Interest

References