Personal Data

Returning?

A A A

Thank you for your interest in the 2024 2024 MPESC-PREP Internship Program at the IU School of Medicine. The application deadline is January 31, 2024. Students will be notified of by March 1, 2024 if they are accepted for the next steps and interview or non-acceptance by March 1, 2024. The program will run for 8 weeks from June 2-July 26, 2024.

Please note this application is ONLY for undergraduate students. If you are currently in high school grades 10-12 (even if taking dual credit college courses) , please consider other programs at the IU School of Medicine (https://medicine.iu.edu/research/training-programs) including the MPESC-PREP high school internship.

For additional information, please contact Shari Parker at mpesc@iupui.edu.

Thank you!

Shari Parker

Program Manager, Summer Internship Programs

Official FIRST NAME - Please provide your first name the way it appears on your social security card or other similar official documents.

* must provide value

Official MIDDLE NAME or INITIAL - Please provide your middle name or initial the way it appears on your social security card or other similar official documents.

* must provide value

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

HOME STREET ADDRESS - Please provide your home address (permanent address) where correspondence can be mailed.

* must provide value

HOME CITY - Please provide your home city (permanent address) where correspondence can be mailed.

* must provide value

HOME STATE - Please provide your home state (permanent address) where correspondence can be mailed.

* must provide value

HOME ZIP CODE - Please provide your home zip code (permanent address) where correspondence can be mailed.

* must provide value

SCHOOL EMAIL ADDRESS - please enter your university or college email address.

* must provide value

PERSONAL EMAIL - please enter your personal email address as school emails may not receive auto-reply or system-generated emails.

* must provide value

Please CONFIRM your PERSONAL EMAIL again.

* must provide value

Please double check your personal email entries - they do NOT match.

Please enter your CELL PHONE NUMBER or number where you can best be reached.

* must provide value

Please CONFIRM your CELL PHONE NUMBER

* must provide value

Please double check your cell phone entries - they do NOT match.

DATE OF BIRTH - please provide your date of birth in the following format (MM-DD-YYYY)

* must provide value

M-D-Y

GENDER

* must provide value

PREFERRED PRONOUNS

* must provide value

RACE

* must provide value

ETHNICITY

* must provide value

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.