By completing this form, you will be considered for all of the UROC programs; however, you may indicate here if you have a preference.
- None - Summer Research Institute Minority Health Disparities Maximizing Access to Research Careers Student Affairs Research Program (STAR) UROC-PREP AWARDSS
Cell phone number (follow this format: 123-456-7890)
May we contact you via text messaging?
Date of birth
Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Year 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
- Select - US Citizen Permanent Resident Other (please specify below)
If other, please specify
Are you Hispanic or Latino?
What is your race?
- Select - American Indian or Alaska Native Asian Black or African American Native Hawaiian or Pacific Islander White Choose not to state
Are you a Pell Grant recipient?
Are you currently eligible to receive financial aid?
With regard to financial aid, are you considered a dependent of your parents?
What is the highest grade or degree your father completed?
- Select - 4 5 6 7 8 9 10 11 high school diploma or equivalent some community college trade school associate's degree bachelor's degree master's degree doctorate degree professional degree such as medical doctor, lawyer, pharmacist or other
What is the highest grade or degree your mother completed?
- Select - 4 5 6 7 8 9 10 11 high school diploma or equivalent some community college trade school associate's degree bachelor's degree master's degree doctorate degree professional degree such as medical doctor, lawyer, pharmacist, or other
Please explain how the group to which you belong is considered underrepresented in graduate education.
Are you currently a University of Arizona student?
Student ID number (UA Students Only)
If not a University of Arizona student, what is your home insitution?
Did you transfer from a two-year college to your current institution?
Have you previously participated in a UROC program?
If you answered yes, which program and when?
What is your overall GPA at it appears on your most recent transcript?
What is your GPA in your major?
How many credit hours/units are you taking this semester?
When do you expect to complete your bachelor's degree?
- Select - December 2015 May/June 2016 December 2016 May/June 2017 December 2017 May/June 2018 December 2018 May/June 2019 December 2019 Have already completed a bachelor's degree
Graduate School Information
Do you intend to apply to graduate or professional school?
If you intend to enroll in graduate or professional school, for which term are you most likely to seek admission?
- None - Fall 2018 Fall 2019 Fall 2020 Fall 2021 Fall 2022
Please note, only fall terms are offered as options because admission to graduate programs for spring semesters is relatively rare.
If you plan to take a break between your bachelor's degree and entering graduate study, please explain how long the gap would be and how you might spend that time.
Are you planning to apply to The University of Arizona?
Please list all the universities you plan to apply to for graduate education.?
What is the highest degree you plan to seek?
- Select - uncertain master's doctorate (PHD) doctor of education (EDD) professional doctorate in law (JD) professional doctorate in medicine (MD) MD and PHD professional doctorate in pharmacy (PharmD) professional doctorate in veterinary medicine (DVM) other professional doctorate, not listed here other
If you chose "other", please explain
Do you plan to take the Graduate Record Exam (GRE)?
If yes, when do you plan to take the GRE?
Do you plan to take the Medical College Admission Test (MCAT)?
If yes, when do you plan to take the MCAT?
Please answer the following series of questions to represent prior experience.
Which college-level course or other ACADEMIC experience have you found most rewarding and interesting up to this point in your career and why?
Describe any prior WORK experience you have had, including the work you did as well as the skills you learned, the name and email address of your supervisor, and how the experience reinforced your interest in graduate study.
Describe any prior RESEARCH experience you have had, including the research work you did, the skills you learned, and the name and email address of your supervisor. Be sure to include any independent study, posters presented, and publications.
Describe any honors, awards, scholarships, or recognition you have received. Provide dates, name of granting agency, and brief context whenever possible. Please do not use abbreviations.
Please answer the following series of questions to represent your personal statement.
BACKGROUND INFORMATION: Who are you? Where are you from? Why did you choose your undergraduate major? (Min 200 words, Max 300 words)
What are your RESEARCH INTERESTS or what would you like to research during your time in UROC? (Min 100 words, Max 150 words)
Why do you want to go to graduate school and what are your plans after graduate school? (Min 100 words, Max 150 words)
What do you hope to gain from your participation in UROC (Min 100 words, Max 150 words)
Final Information & Affirmation
Explain all of the ways in which you heard about the UROC program (s) for which you are applying, and how the contact(s) influenced you to apply.
Have you participated in any formal graduate school preparation programs such Bridges, MARC (U*STAR), MBRS, SCORE, RISE, IMSD, McNair, PREP, TRiO, LSAMP, other? Please indicate the name of the program.
What is the name and title of your program director?
Please provide your program director's email address.
UROC receives more applications from qualified students than we have the capacity to serve. May we share your contact information and research interests with other UA programs?