SIBS Online Application

Name*

First Last

Email*

Phone

Current Address

Street Address City State / Province / Region ZIP / Postal Code Country

Permanent Address

Street Address City State / Province / Region ZIP / Postal Code Country

Sex assigned at birth*

Male
Female
Intersex
Prefer not to respond

Gender Identity

US Citizenship/Residency*

US Citizen
US Permanent Resident
DACA Recipient
Other

Legal Marital Status*

Single
Married
Other

Date of Birth (MM/DD/YY)*

Where did you hear about this program?

Which of the following best describes your ethnicity?*

Hispanic or Latino
Not Hispanic or Latino
Prefer not to respond.

Which of the following best describes your race? Check all boxes that apply.*

Indigenous/Native American (American Indian/Alaska Native)
Asian
Native Hawaiian or Other Pacific Islander
Black or African American
White
Prefer not to respond.
Other (please specify below)

If you chose Other, please specify:

Are you a first-generation college student?

Yes
No

Please let us know if you meet two or more of the following seven criteria in the description below (based on NIH definition of disadvantaged background):*

No, I do not meet two or more of those criteria.
Yes, I meet two or more of those criteria.
I do not know.
I do not wish to answer.

(1) Have you been or are you currently homeless?
(2) Have you been a part of the foster care system at any point?
(3) Were you eligible for the Federal Free and Reduced Lunch Program for two or more years?
(4) Do you have/had no parents or legal guardians who completed a bachelor's degree?
(5) Were you ever eligible for a Federal Pell Grant?
(6) Did you receive support from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) as a parent or child?
(7) Did you grow up in one of the following areas:

(7a) a U.S. rural area, as designated by the Health Resources and Services Administration (HRSA) Rural Health Grants Eligibility Analyzer, or

(7b) a Centers for Medicare and Medicaid Services-designated Low-income and Health Professional Shortage Area.

School you are currently attending:*

Academic Level as of March 2025:*

Major*

Graduation date (expected or actual):

Month

Year

Overall GPA:

On a scale of:

Please list mathematics, statistics and computer science college courses taken and grade received (Year/Course Title/Grade):

In the space below please provide the names, titles, relationships and contact information of two evaluators. They should submit the letters by email to sibs@bu.edu.

Reference #1 (Faculty Advisor or Academic Reference) Name:

Reference #1 Title/Position:

Reference #1 Relationship to Applicant:

Reference #1 Institution or Company:

Reference #1 Address (Street, City, State, Zip):

Reference #1 Phone:

Reference #1 Email:

Reference #2 (Academic or Other) Name:

Reference #2 Title/Position:

Reference #2 Relationship to Applicant:

Reference #2 Institution or Company:

Reference #2 Address (Street, City, State, Zip):

Reference #2 Phone:

Reference #2 Email:

Personal Statement: In the space below please provide a statement describing your background and experience, along with reasons for your interest in our program.*

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