Advancing Native American Diversity in Aging Research Registration

REGISTRATION INFORMATION

Name *

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Last

E-mail *

Are you a Permanent Resident of the U.S.? *

Yes
No

If no, Citizenship

MAILING ADDRESS:

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CURRENT ACADEMIC INFORMATION

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How did you learn about this course? *

What type of student in the 2022-2023 academic year? *

Senior student
Junior student
Sophomore Student
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Area of study if determined *

Degree year *

ADDITIONAL INFORMATION

If you are a member of an under-represented minority in science, please indicate below: (for U.S. Citizens and Permanent Residents only):

If Native American, please specify tribe:

Gender *

Male
Female

Do you have a physical or mental impairment that substantially limits one or more major life activities?

No
Yes

FINANCIAL AID INFORMATION

Full financial assistance is available for participants in this course.

If applicable, please describe any financial considerations associated with your participation in this course:

REQUIRED SUPPORTING DOCUMENTATION

A copy of your current resume (optional). Please Click Here for more information on creating a resume.
A copy of your college transcript.
A brief statement of your reasons for wanting to take this course and respond to these questions:
1. Outline your background in MSTEM, including courses taken.
2. What experience, if any, have you had with research?
3. Are you currently involved in any research projects? If so, please describe.
4. Please list and describe all leadership roles you have held and your volunteer experiences.
5. Please describe your academic, career, and research goals and how this course will contribute to those goals.

Current Resume

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Allowed Formats: .pdf, .doc, .docx

College Transcript

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Brief Statement/Questions

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EVALUATIONS

Applicants should request one (1) written letter of recommendation from an individual familiar with the applicant's research, leadership background, and career goals. Evaluations may be submitted with other application materials by the candidate or sent directly to the MWRI/PDC Admissions Office, frontiers@mwri.magee.edu, by the evaluator by the deadline listed above. This letter of recommendation may come from a community member, educator, or supervisor.

Evaluation 1

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Allowed Formats: .pdf, .doc, .docx

Registration

REGISTRATION INFORMATION

MAILING ADDRESS:

CURRENT ACADEMIC INFORMATION

ADDITIONAL INFORMATION

FINANCIAL AID INFORMATION

REQUIRED SUPPORTING DOCUMENTATION

EVALUATIONS

THE PITTSBURGH DEVELOPMENT CENTER