Enrollment Information
1-800-422-4LLU (1-800-422-4558)
Please see the scholarship page for details regarding Summer Research Scholarships. Application forms for scholarships will be given out and posted after the noon conferences. You will need to hear the faculty presentations at the noon conferences to select your project.
Send application form by mail or fax to:
Phone: (909) 558-4630
Fax number: (909) 558-4146
Name_______________________________ Date________________
Year of graduation from LLU School of Medicine__________
Please list your three choices in order of preference for summer research projects and a statement of the reasons for your choice.
Note: List three different faculty/laboratories (not two or three different projects for the same faculty member). Faculty will be funded for only one project.
1.
Project title:_______________________________________
Researcher:________________________________________
Reason:___________________________________________
Project discussed with faculty researcher? Yes_____ No_____
2.
Project title:_______________________________________
Researcher:________________________________________
Reason:___________________________________________
Project discussed with faculty researcher? Yes_____ No_____
3.
Project title:_______________________________________
Researcher:________________________________________
Reason:___________________________________________
Project discussed with faculty researcher ? Yes_____ No_____
Name:______________________________________
SS#:________________________Telephone:_______________________________
Street:_______________________________________________________________
City:_____________________________State:_______Zip Code:________________
To assist the Research Selection Committee, please provide the following information:
1. What specific career goals will this research experience help you accomplish?
2. What factors influence your decision to pursue a summer research program?
3. List any prior research experience.
4. Are you a member of the Walter E. Macpherson Society?
5. Please provide any other information about yourself that pertains to this program.
I understand that I am applying for a eight-week program of research.
Signature:___________________________________________ Date:________________