Your Name
Your Email
Phone
Age
Academic Year FrSoJrSr
Undergraduate Institution
Major field of study
Cumulative GPA:
Requested length of research internship:
Requested internship start date:
Requested internship end date:
I am interested ONLY in internships that are paid: yesno
Faculty with whom you would like to work (you may list up to three):
Prior laboratory and field experience or special skills that you possess:
Scientific diving certified? Please indicate: UH or Other. *If other, you will be required to submit a letter of reciprocity if selected for an internship. certifiednot certifiedUHOther
Contact information for one referee who is familiar with your academic or scientific work. Include name, affiliation, position, email, and phone number:
Specific laboratory or field experience/skills that you are looking to acquire:
Please state your interests for wanting to participate in research at HIMB. Include your long-term research and career goals, as well as the importance of HIMB as a location (one page maximum)
