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ProvBos CFAR Summer Intern Request
(To be completed by requesting faculty member no later than March 1st)
Date:
*
+
Year the Summer Student is requested for:
*
2018
2019
2020
2021
2022
2023
2024
2025
Mentor Name:
*
Mentor's e-mail address:
*
Attach the Mentor's Biosketch
Which CFAR group will the student be working with
(check all that apply):
*
Developmental Core
BioBehavioral Sciences Core (BBSC)
Biostatistics Core
Basic Sciences Core (BSC)
Substance Use Research Core (SURC)
HIV/TB Scientific Working Group
C-CERC (Community Engaged Research Council)
Other (please indicate)
Other (please indicate)
Project Location:
*
Boston - Boston University/BUMC/BUPSH/BMC
Providence (Brown Univ., RIH, TMH, Providence VA)
Describe the project the student will be working on, include funding source, if applicable. (Please attach abstract if available)
*
0/300 words
Attach abstract if available
Describe the specific responsibilities of the student on the project:
*
0/300 words
Describe the research skills and/or knowledge that will be provided to the student by working on this project
*
0/300 words
Have you already identified an undergraduate student for this internship?:
*
Yes
No
Student Name:
Student e-mail address:
*
Is the student a member of an underrepresented racial/ethnic groups?
*
Yes
No
Please select one:
African-American
Hispanic
American Indian
Alaskan Native
Native Hawaiian
Pacific Islander
Other
Other
Does the student self-identify as coming from a disadvantaged background?
*
Yes
No
Attach the student's resume