Undergraduate Research Scholarship Program Submission Form

Undergraduate Research Scholarship Program Submission Form
For application requirements and information, visit the MSA website: https://microscopy.org/undergraduate-research-scholarship-program
Applicant Information
Applicant Name

First Name/Given NameLast Name/Family Name
Applicant Email Address
example@example.com
Applicant Phone Number

Country CodeArea CodePhone Number
Affiliation/University
e.g, Arizona State University
Expected Graduation Date
Month YEAR (e.g., June 2025)
Date of Birth
Racial/Ethnic Background
This is an optional question.
I understand that in order to be eligible for this scholarship, I must be a current member of MSA at the time of application, and that if I am not, my application will not be considered.
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Permanent Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Research Proposal Information
Title of Proposed Research
Site/Location of Research
e.g., University of Oregon
Requested Funding Amount (USD)
Statement of Interest
Please provide a brief statement of your interest in this research topic.
Research Proposal

Please upload your complete research proposal.
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Research Proposal Budget

Please upload the proposed budget for your research proposal. This file should include your expected expenses and any sources of additional funding.
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Applicant's Curriculum Vitae (CV)

Please upload a copy of your CV.
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PI Letter of Support

Please upload a letter of support from your PI.
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I confirm that the letter of support provided by my PI includes details regarding a plan to complete my research, should I graduate early, leave the lab, or be otherwise unable to complete the research myself.
Should be Empty:

Applicant Information