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The 2023 Lombardi Summer Research Application
Online Application
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* Indicates required question
Name (First & Last)
*
Your answer
Gender
*
Female
Male
Prefer not to disclose
Your Race
*
Black or African American
White
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
Prefer not to disclose
Other:
Required
Your Ethnicity
*
Hispanic or Latinx
Not Hispanic or Latinx
Disability?
*
No
Yes
Prefer Not to Disclose
I am part of an Underrepresented Population in Biomedical Research. (Find out how to determine this at
https://diversity.nih.gov/about-us/population-underrepresented
)
*
Yes
No
Prefer Not to Disclose
Interested in Virtual Research Experience if In-Person Is Not Available for Summer 2023?
*
Yes
No
Other:
Current Educational Level and Anticipated Graduation Date
*
Your answer
Name of Your Current School
*
Your answer
Overall GPA at Your Current School
*
Your answer
AP Science (for High School Students)
Your answer
Major in Your Current School (for Undergraduates)
Your answer
Research Interest & Experience (250 words limit)
*
Your answer
Estimate starting date (MM/DD/YYYY) & End date (MM/DD/YYYY)
*
Your answer
Your Birthday (MM/DD/YYYY) if under the age of 18
Your answer
Your Personal Email Address
*
Your answer
Your Contact (phone #)
*
Your answer
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