Part I: Science Internship Program Online Application [This is a sample application form. Data will not be collected.]

Applications must be submitted by March 27, 2017.

Your UserName: new.applicant
Your Password: na2400

Please remember this information in order to log in again and retrieve your application.
Applicant Information
If you need disability-related accommodations, please contact us.

First Name
Last Name

Preferred Name or Nickname (Optional)

Street Address

Zip Code
City
State
Country
Country

Home Phone Number with Area Code

Cell Phone Number with Area Code

Email Address

Confirm Email Address
Date of Birth

Gender Identity
    Male       Female       Transgender       Decline to State  

Do you currently attend The Harker School?
    Y       N
Name of High School

Is your school private?
    Y       N

What state is your school in
Harker students will undergo an internal prescreening process. Harker applications must be submitted by March 22, 2017.
Current Grade Level in High School

For example, a current 10th grader will be a rising 11th grader by the time the program starts.
High-School Cumulative Unweighted GPA
out of 4.0
High-School Administrator Contact Information
This person will be contacted by SIP if you are unable to upload your unofficial transcript.
Name

Phone Number with Area Code

Email Address
Please click "Upload" if you wish to send us your unofficial transcript.
Please note: If you are unable to upload your unofficial high-school transcript,
SIP will contact your high-school administrator to obtain your transcript after you have submitted part I of your application.
Your Areas of Interest
Please rank up to three (3) of your areas of interest (enter 1, 2 or 3).
These will be used to help determine a suitable project for you.
You can find more information on SIP research projects here to help you select your areas of interest.
You may also click on any of the areas listed below to see projects associated with that field.
Your Skills
Specify any skills you have:





* Being skilled in Computer Programming means that you are comfortable writing computer programs
Please list your experience in programming
Please list your other skills

Specify any skills you would like to acquire/improve:







Please list other skills


Additional Information
Please use this space to add any additional information you would like us to have

Parent and/or Guardian Contact Information (shown as Guardian 1 and Guardian 2)
Please check this box if you have only one guardian
Guardian 1
Same as Applicant's Address
Relationship to Applicant
First Name
Last Name
Street Address

Zip Code
City
State
Country
Country

Phone Number with Area Code

Email Address