UIC PBRC PREP 2024-2025 Application
Due: March 1, 2024, 5P.M.; UIC PBRB PREP Dates: June 6, 2024-May 31, 2025
Name
First Name
Middle Name
Last Name
Gender
Male
Female
Other
Current Mailing Address
Street Address
Street Address Line 2
City
State
Postal / Zip Code
Permanent (Home) Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Telephone Number
-
Area Code
Phone Number
Mobile Telephone Number
-
Area Code
Phone Number
E-Mail Address (preferably NOT a university address)
example@gmail.com
Citizenship
U.S.
Permanent Resident
National
Other
Other
Race/Ethnicity
Am. Indian/AK Native
Asian
Black/African Am.
HI Native/Pac. Islander
White
Hispanic/Latino
Not Hispanic/Latino
Mixed/Other
Current or Previous Academic Institution
Institution Name and Location
Current or Previous Major
Major and Overall Grade Point Average (4.0 Scale)
Complete Degree(s)
Degree, Graduation Date, and GPA
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Previous Research Laboratory Experience
Name of Program, Dates, Location, Name of Mentor, Brief Description of Research
Other Relevant Experience (teaching, internships, paid, or unpaid jobs)
Activity, Location, Supervisor/Mentor, Dates (mm/yyyy-mm/yyyy)
Have you taken the Graduate Record Examination (GRE)?
Date, Analytical Writing Score, Verbal Reading Score, Qualitative Reasoning Score
Have you taken the Medical College Admissions Test (MCAT)?
Date, Total Score
Have you previously applied to graduate or professional school?
Program (ex., PhD in biochem), Institution, Start Date, Admission (Yes, No, Pending)
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Research Interests
Please list scientific areas/disciplines/questions that interest you
Potential UIC Faculty Mentors
List up to three (3) potential faculty mentors that interest you (Name and Department)
Letters of Recommendation
Please list the names of three individuals writing letters of recommendation for you.
How did you hear about UIC PBRC PREP?
Please indicate source
Additional Information Needed
1. Personal Statement: Describe your future training and career goals, and why UIC PBRC PREP will help you achieve your goals. Include a description of your specific research interests and what UIC faculty members might serve as good mentors for you. Describe your academic and research strengths (e.g., previous coursework, research experiences) as well as your personal characteristics that make you a good candidate. Describe the weaknesses that you perceive, and how UIC PBRC PREP will help you improve. 2. Letters of Recommendation: Ask three individuals to directly email their recommendation letter to pbrcprep@uic.edu. These individuals should be able to discuss your academic ability to conduct independent research, evaluate your potential for graduate school, your ability to organic and express ideas clearly, and your potential for critical and analytical thinking. 3. Transcripts: Please email an unofficial copy of your transcripts to pbrcprep@uic.edu.
Contact Information
UIC PBRC PREP, c/o Bernie Santarsiero, Program Coordinator, UIC, 619-University Hall (MC-192), 601 S. Morgan St., 312-996-0754; Confidential Email Address: PBRCPREP@UIC.EDU.
Personal Statement
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