Undergraduate Summer Research Award Application

Name Name * First Last
Email *
Phone Phone * - ### - ### ####
Current Academic Status *

Current Academic Status First Year Student Second Year Student Third Year Student Fourth Year Student Other Other
Race/Ethnicity (optional)

Race/Ethnicity (optional) Alaska Native African American Asian Native American Native Pacific Islander Caucasian Hispanic/Latino Decline to answer Other Other
Department, Division or School *

Department, Division or School Physics Chemistry & Biochemistry Jacobs School of Engineering Math Other Other
Major *
Minor (if applicable)
Current Cumulative GPA *
If you feel your GPA does not accurately reflect your capabilities, please explain here.
Expected Graduation Date (month/year) *
Are you planning to attend graduate school? *

Are you planning to attend graduate school? Yes No Undecided
If yes, what area of study are you planning to pursue in graduate school?
Personal Statement
Please tell us about yourself, why you would like to participate in the program and what are your career goals in 300 words or less. *
Maximum of 300 words allowed. Currently Entered: 0 words.
Please list any relevant college level courses and labs you have taken or are currently taking.
Please list any awards, honors, or other notable accomplishments, if applicable. (in the Blank)
Do you have prior research experience? *

Do you have prior research experience? Yes No
If yes, please provide a brief description of the research and any activities and/or publications
you were involved in.

Also include the institution and research advisor's name
Research Plan/Proposal
Please make certain to create this plan with your advisor's input and approval. *
Maximum of 300 words allowed. Currently Entered: 0 words.
Please confirm that you are available to perform research on a full-time basis, in a research topic for 10 weeks (June 28 -September 3).

Please confirm that you are available to perform research on a full-time basis, in a research topic for 10 weeks (June 28 -September 3). Yes No
Faculty Advisor/Endorser Information
Full Name / Department / Email Address *

Please confirm that you are not receiving any other support which would impact your ability to utilize the summer research award. Students should discuss potential impacts on their financial aid with a counselor at finaid@ucsd.edu, (858) 534-4480.

Please confirm that you are not receiving any other support which would impact your ability to utilize the summer research award. Students should discuss potential impacts on their financial aid with a counselor at finaid@ucsd.edu, (858) 534-4480. Yes No

Please upload Faculty Endorsement Letter here:

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