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* 1. Do you give permission for NBTS program staff to access or share your student information for program purposes? 

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* 2. Your full name

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* 3. Do you self-identify as Native American, Alaskan Native or Native Hawaiian?

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* 4. Where will you be enrolled as an undergrad student in summer 2023?

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* 5. Your student email:

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* 6. Please enter the same student email again, thanks:

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* 7. Best phone to reach you, if needed:

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* 8. Your mailing address:

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* 9. What is your major?

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* 10. When do you expect to complete your bachelors degree?

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* 11. Do you have an internship secured for summer 2023?

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* 12. If you have an internship secured, please describe it briefly. Include the topic, start and end dates and the organization or lab you will be working with.

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* 13. Do you need help finding and securing an internship for summer 2023?

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* 14. What type of internship are you interested in? What would you like to learn or gain from an internship?

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* 15. Part of this funding is pairing students with mentors during the internship. Mentors may be professors, supervisors, or other professionals in your field of study willing to help coach and provide helpful guidance to you as you pursue your goals.  We will match you with a mentor and you can decline at any time. 

Are you willing to meet with a mentor periodically during your summer internship?

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* 16. Do you have any other questions for the program manager? 

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