Graduate School of Biomedical Sciences

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Program for Undergraduate Research Experience (PURE)
Application Form

      Fall program                      Spring program               January program

 
Name
 
  School Address (Where you live at school)
Address
City
State
Zip
 
Phone
E-mail
 
Minority
Status
 
Are you a first generation college student  
 
Describe your educational and career goals. (100 word minimum)
 
What are your primary objectives for participating in this program?  (100 word minimum)
 
Describe any relevant additional awards or research/work experience.
 
Major area of study
Minor area of study(if applicable)
Undergraduate Institution
Year in school
Year you will graduate
   
Are you considering an application to a PhD program?

Yes      No

Are you considering an application to a MD program?

Yes      No

Are you considering an application to a dual MD/PhD program?

Yes      No

 

How did you hear about the Internship Program?    

 

List the top faculty members you wish to work with for your internship:


 

Signature:

NOTE: For on-line submitted applications, entry of your name in the signature box will be considered a signature. Your signature will verify the completeness of your application. 

Applications must be submitted at least 4 - 6 weeks prior to the start of the program

 

If you have any questions about the application process, please contact:

Program for Undergraduate Research Experience (PURE)
Medical College of Wisconsin
8701 Watertown Plank Road
Milwaukee, WI 53226-0509

Phone: 414/955-4407; Fax: 414/955-6555
gberst@mcw.edu


Send OFFICIAL university transcripts and letters of recommendation to the above address.  

The Registrar from your campus sends transcripts directly to the The Medical College of Wisconsin.  Unofficial transcripts will not be reviewed for admission to the program. 

 

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Page Updated 07/15/2014