SURF 2021 PARTICIPANT INFO REQUEST

SURF 2022 PARTICIPANT INFO REQUEST

We are so excited to have SURFers fully in person this summer! Below is a list of info and items we need to kick off a great summer. As a reminder, SURF starts May 23rd and we will be hosting activities and trainings that day.
Basic Personal Info
Name *

First Name Last Name
Nickname or Name you prefer
Preferred pronouns
E-mail (preferred email if you have more than one) *
Mobile Phone Number *

Area Code Phone Number
Date of Birth *

Month Day Year
Mailing address for receiving your stipend check *

Street Address

Street Address Line 2

City State

Zip Code Country
Medical Information
Do you have active health insurance? This is required of all SURF participants. *

Yes No
Rutgers is requiring students to receive the COVID-19 vaccine. Please let us know your current status of vaccination: *

I have already completed my vaccination (Moderna, Pfizer, or Johnson & Johnson) I have started my vaccination and will be complete by the start of SURF I have an appointment for vaccination and will be complete by the start of SURF I do not currently have plans for vaccination but will be complete by the start of SURF I qualify for medical exemption from receiving vaccinations
Please upload a copy of your COVID-19 vaccine card(s) including any booster.

Browse Files

Cancel of
If you have a medical exemption by Rutgers excluding you from receiving the vaccine, please upload documentation/proof here.

Browse Files

Cancel of
Rutgers Logistics
If you are not a Rutgers student, you will need to obtain a guest NetID and a guest Rutgers ID card. Please follow the instructions posted here to do so.
Do you have a Rutgers NetID? *

Yes No
Your current Rutgers NetID (if applicable)
If you were formerly affiliated with Rutgers, please enter the NetID you were assigned at that time.
Do you have a Rutgers Connect Account (for access to Microsoft OneDrive for file sharing) *

Yes No
Are you currently employed by Rutgers? *

Yes No
If Yes, please provide your employee ID#
Parking
Will you require a summer parking permit? *

Yes No
If you are a non-Rutgers student and you need parking for the summer, please go this link to register your vehicle.

If you are a Rutgers student and already have parking permission that expires on 8/31, you are all set for the summer, but if you don't you'll need to purchase summer parking online.

A guide to where you can park for the summer will be forthcoming.
On-Campus Housing

Housing will be available in one of the dorms at a cost of $256 per person per week. Information will be provided if you check yes below.
Will you require on-campus housing? *

Yes No
Werblin Gym Access

If you are a Rutgers student you already have gym access. Non-Rutgers students can purchase summer gym membership for approximately $50. Purchase details will be provided if you check "yes" below.
Would you like access to Werblin Gym? *

Yes No
Training
All SURF students need to complete online lab safety/biosafety/bloodborne pathogen training that is valid until at least August 1, 2021. Instructions for accessing this training are posted here. You will not be able to participate in lab work until this certificate is provided to SURF.
Have you completed the general laboratory safety and blood borne pathogen/biosafety training at Rutgers University? *

Yes No
Upload Lab Safety/Bloodborne Pathogen/Biosafety Certificate *
SURF Activities & Paperwork
SURF T-shirts and lab coats will be provided - please select a size below. We also need your completed FERPA form, Media Consent form, and W-9 form, all of which can be accessed at this link. Lastly, we need your selfie. Please upload below.
Your t-shirt & lab coat size *

Small Medium Large X-Large XX-Large
Please provide us the weblink to your LinkedIn profile. Make sure this is a valid link. *
Please provide your ORCID (https://www.libraries.rutgers.edu/services-for-researchers/orcid) or for non-Rutgers individuals (https://orcid.org/my-orcid) to set one up. *
Upload your selfie *
Upload your completed FERPA form *
This is pre-filled. Just sign and date it and include your student ID number if you are a Rutgers student. No need to have it notarized.
Upload your completed Media Consent form *
Add your full name, sign it and date it.
Upload your completed W-9 form *
To get you into the Rutgers pay system, it is essential that you fill out the attached W-9 form. Fill in sections 1, 5, and 6, plus your cell phone number and email address (all fillable fields), then sign and date the bottom. MAKE SURE TO USE THE ADDRESS WHERE YOU WANT TO RECEIVE YOUR STIPEND CHECKS. For security reasons, DO NOT include your social security number. We will call you to obtain it over the phone.
Your music preferences - pick as many as you like!

Dance/Electronic New Age Soul/R&B Pop Alternative Jazz Country/Folk Reggae Classical Rock Blues
Food preferences - pick as many as you like!

Pizza Sandwiches/subs Chinese Mexican Indian
Any dietary restrictions?
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SURF 2022 PARTICIPANT INFO REQUEST

Basic Personal Info

Medical Information

Rutgers Logistics

Parking

On-Campus Housing

Werblin Gym Access

Training

SURF Activities & Paperwork