Please provide the following information about yourself, your lab and your summer project. Ensure all information is correct before submission, as this will become your official record with us.

* 1. Last Name:

* 2. First Name:

* 3. MIT Email Address

* 4. Dorm Room (Entry and Room Number)

* 5. POD Number

* 6. In which department at MIT are you working?

* 7. Lab Name (if applicable)

* 8. Lab Location

* 9. Direct Supervisor Name

* 10. Direct Supervisor Email

* 11. Faculty Mentor Name

* 12. Faculty Mentor Email

* 13. Brief Biography: Write 3 - 4 sentences about yourself: where are you from, what is your major, what are your research interests, hobbies, goals, etc?

Descriptive Abstract

* 14. Title

* 15. Abstract

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