Application - ASPET Summer Undergraduate Research Fellowships
The American Society for Pharmacology and Experimental Therapeutics
University of Cincinnati, Cincinnati Ohio
June 16 - August 22, 2008*

Name______________________________________________________________Date_____________ .................(First) -- -------------------------(Last)------------------------------------------------Middle
Permanent Address					College Address
Street:					Street:
City/State/Zip:					City/State/Zip:
Phone:					Phone:
E-Mail Address:					Overall GPA:
College or University:					Expected Graduation Date:
Current Major:					UC id (if available):
How did you learn about this program?
Do you expect to apply to a post-graduate program after completing your undergraduate studies? Please indicate this in the boxes below.
___MS	__PhD	__MD	__No	__Not Sure	_______________________________Other
Have you had any laboratory experience? -___Yes ___No
If Yes, indicate the length of time, and the area of research:
Country of citizenship or permanent residence:
Optional: .Ethnicity: __________________Gender: ___ Disabilities: __________-
* If the program dates conflist with the academic schedule of your institution, what dates would you be available? _____________________________________________
Applicants are required to supply an official academic transcript, two letters of recommendation sent directly to us by the recommenders, a resume listing prior job experience, honors and accomplishments, and a brief narrative discussing interest in this program, research interests and career goals. Applications from women and students of under-represented groups are strongly encouraged. Additional information about the program and copies of this application can be obtained from our website at http://www.med.uc.edu/pharmacology/aspet.surf . Applications must be postmarked no later than February 1, 2008 and sent to: ASPET SURF Program 231 Albert Sabin Way, PO Box 670575 Cincinnati, OH 45267-0575 Questions may be referred to Nancy.Thyberg@uc.edu