Undergraduate Research Fellowship Application Survey

New (applicant has not previously submitted a Maryland-HHMI fellowship application)

Resubmission (applicant has previously submitted a Maryland-HHMI fellowship application but was not funded)

Renewal (applicant is a current or former Maryland-HHMI fellow)

Name of Student:

Name of Faculty Mentor:

Department affiliation of Faculty Mentor:

Name of Faculty Co-Mentor (if applicable):

Department affiliation of Faculty Co-Mentor (if applicable):

Project Title:

Proposed Starting Date* :

*Fellowships awarded in the fall may begin no earlier than Dec. 15; fellowships awarded in the spring may begin no earlier than May 15

Student Personal Data

Student ID Number:

Major:

Credits Earned:(as of the end of the current semester)

Expected Date of Graduation:

Cumulative GPA:

Science GPA:

Local Address:

Permanent Address:

Telephone Number:

Email Address:

HHMI Fellowship Support
Please note that students applying for Summer 2018 funding through the HHMI Undergraduate Fellowship program will be considered for Summer 2018 Maryland Summer Scholars awards automatically, through the HHMI application process. Students who wish to have their Summer 2018 HHMI research proposals considered for an MSS award do not need to submit a separate MSS application.

Fellowship period

Amount of research supply funding requested

Project Information

Project involves vertebrate animal subjects. If yes, please provide IACUC protocol approval number

IACUC protocol approval number

IMPORTANT: Your application is not complete until you have submitted the following via email to HHMI@umd.edu. The faculty mentor letter of support may be sent separately. Please note that only MS Word (.doc or .docx) and Portable Document Format (.pdf) files will be accepted. See hhmi.umd.edu/undergraduateresearch fellowships/howtoapply for complete application instructions instructions.

Personal statement (new applicants and resubmissions only)

Proposal abstract (new applicants and resubmissions only)

Proposal narrative

Budget

Unofficial university transcript

Applicant's curriculum vitae (new applicants and resubmissions only)

Faculty mentor letter of support