Official LAST NAME. Please provide your LAST NAME as it appears on your social security card, or other similar official documents. If your last name is more than one word, please include it here with with caps, or no caps the way it appears on your documents -example: de la Vega.
* must provide value
First and Middle Names. Please provide your first and middle names the way they appear on your social security card, or other similar official documents. First and Middle Name/s:
* must provide value
School Email. If you have a school issued email, enter here.
enter a valid email address to receive your confirmation
Personal Email. IMPORTANT: Make sure the email address you provide here is working for you. This is the email where you will receive the follow up links for your application.
* must provide value
Personal email address
Your personal email again to ensure accuracy.* must provide value
This helps ensure accuracy
Please double check your personal email entries - they do NOT match
Phone number where you are best reached?* must provide value
(###) ###-####
Name of Parent(s) or Guardian(s) that you live with. If you have a shared custodial arrangement, please add name/s of other custodial parents on the next question.
* must provide value
Custodial parent/s or legal guardian/s
Name(s) of Additional Custodial Parents or Legal Guardians with shared custody.
Custodial parent/s or legal guardian/s
Home Address. Enter your complete address here, with city, ST and zip* must provide value
address
Best phone number where one of your parents can be reached* must provide value
If you need to take a break to get your parents email address, choose the 'Save & Return Later' option at the bottom of this form. Please be sure to enter your email into the system so they can send you the form with your saved info.
Parent email. Please provide an email address for the parent/guardian you live with that is going to complete the parent portion of the application. Please enter the correct email.
* must provide value
If needed, help your parents create an email account
Parent email 2. If possible, provide an email address for a second parent.
If needed, help your parents create an email account
Which high school do you attend?* must provide value
Official School Name
In which COUNTY is your school located?* must provide value
Marion Boone Clinton Hamilton Hancock Hendricks Johnson Morgan Shelby Other
County location of your school
In which county is your school located? If your school is outside Indiana, provide the name of the county first, followed by the name of the state where your school is located.
County location of your school
Expected Graduation Year* must provide value
2021 2022 2023 2024
graduation year
Date of Birth* must provide value
(DD/MM/YY)
Gender* must provide value
Female Male Non-Binary
Race* must provide value
American Indian or Alaska Native Asian Black or African American Native Hawaiian or Pacific Islander White Multi-Racial Unknown
Choose most descriptive option
Ethnicity* must provide value
Not Hispanic or Latino Hispanic or Latino Unknown
Choose most descriptive option
If accepted, how will you travel to your internship location?* must provide value
I will drive my own vehicle I will drive a family vehicle Someone else will drive me I will walk, bike or take bus
Have you ever had a Network ID or email for IUPUI or an IU campus? Yes No
What is the username you had for your IU system or IUPUI network ID or email? If you do not remember, simply write 'Do Not Remember'
In which program are you MOSTLY interested to apply? You can review options at https://www.IndyProjectSEED.org/summer2021programs.pdf
* must provide value
Summer Research Program - IU Simon Comprehensive Cancer Center Future Scientists Program - IU Simon Comprehensive Cancer Center Indianapolis Project SEED - American Chemical Society Purdue Project SEED - American Chemical Society Indianapolis Project STEM - Indiana CTSI, IU School of Medicine Nanotechnology Program - IUPUI School of Engineering and Technology Physics Program - IUPUI School of Science Project Spark - Crispus Attucks HS ONLY Your Team Can Decide which program is best for me
Choose Program Best For You
If you're NOT selected for the program you selected above, what are 1-2 other programs you believe would be a good fit for your interests? Explain why. * must provide value
NIH Under-Represented Populations Criteria. Please read sections A and C on link. Explain what specifically about your background identifies you in the NIH definition of disadvantaged or underrepresented in the biomedical, clinical, behavioral, and social sciences. Please provide relevant and sufficient detail for the admissions committee to review. https://grants.nih.gov/grants/guide/notice-files/NOT-OD-20-031.html
* must provide value
Optional Question - Not Required. NIH Under-Represented Populations Criteria. Please read sections A and C on link. Explain what specifically about your background identifies you in the NIH definition of disadvantaged or underrepresented in the biomedical, clinical, behavioral, and social sciences. Please provide relevant and sufficient detail for the admissions committee to review. https://grants.nih.gov/grants/guide/notice-files/NOT-OD-20-031.html
Personal Statement. Please copy and paste your personal statement into this text box, describing why you are interested in participating in this oncology focused Summer Research Program with the IU Simon Comprehensive Cancer Center. 200 words is sufficient.
* must provide value
personal statement essay
Optional Question - Not Required. Personal Statement. Please copy and paste your personal statement into this text box, describing why you are interested in participating in this oncology focused Future Scientists Program with the IU Simon Comprehensive Cancer Center. 200 words is sufficient.
personal statement essay
Financial Eligibility for Project SEED. See link with income chart per household number to determine family income eligibility guidelines for Project SEED participation. Based on your family's 2020 family income, do you qualify? https://www.indyprojectseed.org/financial.pdf
* must provide value
YES, I'm sure YES, I think I do Maybe No
OPTIONAL QUESTION - NOT REQUIRED. You are welcome to write a personal statement into this text box and tell us why you are interested in applying to the summer program/s. 200 words is sufficient.
personal statement essay
How did you first learn of these programs?* must provide value
Past Intern Teacher Website Other
Who was the past intern? How do you know each other?
What is the name of the teacher who informed you about these programs?
Explain details of how you learned of these programs
Enter your name on this line to certify you have completed this form with accurate information. * must provide value
Type your name here
Submit
Save & Return Later