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The Cancer Prevention and Research Institute of Texas (CPRIT)
Summer Undergraduate Research Prog at MD Anderson
Current mailing address
Permanent mailing address
Date of birth
Country of citizenship or permanent residency
If non-US citizen, current visa status
Have you ever been convicted of a felony?
If yes, provide details including dates
College or University (Name, Location)
Dates Attended, From/To (month/year)
Major Field of Study
Minor (if applicable)
Classification as of Spring 2012 (Junior, Senior, etc.)
Expected Date of Graduation
Academic awards/honors (college)
If you have had a significant (1 semester or greater) interruption in your college studies, please provide details.
If yes, provide details
Two references are required in support of your application. List names, credentials, physical addresses and email addresses for individuals who will provide references on your behalf.
Indicate how you know these individuals and why they have been selected to provide a reference for you.
A limited number of spots in UTHSC-Houston student housing is available and affordable. The cost of this housing will be at the student's expense.
Will you require housing?
As described in the CPRIT Summer Undergraduate Research Program Announcement, a stipend of $5000 will be provided for the 10-week program.
Indicate if you plan to pursue post-graduate education.
If Other, provide details
Provide a brief description of your future career goals
Describe how this program will help you achieve your career goals
If selected, you will perform research sponsored by CPRIT within the laboratory of an assigned faculty mentor at the University of Texas, MD Anderson Cancer Center.
In order to match your interests with available mentors, please attach a description of any past research experience, specific areas of research interest and particular situations that led to this interest.
The format for this description is:
Font: Arial or Helvetica
Size: 12pt or greater
Length: 500 words or less
This application must be accompanied by
Current college transcript (may be attached or sent separately)
Two letters of reference (may be attached or sent separately)
Description of Research Experience and Interest (attach below)
All materials must be received by December 31, 2011. It is the applicant's responsibility to ensure that the application and supporting documentation (letters, transcripts) is submitted on time.
Letters of reference and current college transcript may be submitted via email to:
Please include your name in the subject line of emails submitted to
. Late applications or applications that do not follow the guidelines will not be considered.
I understand that all application material submitted to The University of Texas M. D. Anderson Cancer Center becomes the property of the Institution.
I understand this information will be used to determine my eligibility for appointment and training.
I agree to notify the proper M. D. Anderson officials of any changes in the information provided.
I certify that the information in this application is accurate and complete to the best of my knowledge.
I acknowledge that the submission of any false information is grounds for the rejection of my application, withdrawal of acceptance offer, appointment revocation, or appropriate disciplinary action after appointment.