SURF Application Form

Personal Information

Last Name

First Name

E-mail Address

Date of Birth

Current City, State

Permanent City, State

Gender

Resident Status

Ethnicity

Academic Information

Home Institution

Expected Graduation Date

Planned Major

Current Cumulative GPA

Career Information

Current Career Goal

Current Degree Goal

Program Information

First Choice SURF Mentor

Second Choice SURF Mentor

Third Choice SURF Mentor

Are you able to begin the program on June 4?

Yes
No

Do you need housing in Boston?

Yes
No

How did you hear about the SURF program?

Application Information

Please explain why you would like to participate in the program. Your answer should be approximately 400-1000 words. You may want to incorporate your reasons for seeking this type of experience, the appropriateness of your preparation for full-time lab research, and/or your particular academic and career interests.