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APPLICATION FORM FOR KHORANA SUMMER RESEARCH

Khorana Scholars Program, 2009

1. Name (last, first)

2. Male ___ Female ____

3. Email

4. Telephone

5. Institution

6. Major field of study

7. Degree program (e.g., BS, MS, Integrated BS/MS)

8. Years of study completed

9. Cumulative Grade Point Average

10. Research interests, possible project ideas, faculty you might like to work with and
what you hope to gain from this experience (please use up to up to one separate “page”)

11. Research experience, technical background, other internships, courses, lab work,
techniques exposed to and past lab experience (please use up to up to one separate
“page”)

12. Supporting documentation including a current transcript and two letters of


recommendation from a faculty member, advisor or lab supervisor.

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