Welcome!
We are happy to know that you are interested in the DTG Summer Research Program and look forward to reviewing your application.
If you have any questions or trouble completing this application please contact us for assistance: bridges@vcu.edu
You can save this application and return later to complete. Scroll to the bottom of the application and hit "Save and Return". Be sure to copy or write down the Return Code which will show up on your screen. Without it, you will not be able to return and continue this survey. Once you have the code, click Close and follow the other instructions on this page.
First Name:
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Last Name:
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Legal Sex
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Female Male Other
Legal Sex is defined as the sex indicated on your birth certificate
Date of Birth:
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Today M-D-Y
Place of Birth City/Country:
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Street/Apt# (if applicable):
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City:
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Zip Code:
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Is your current address the same as your permanent address?
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yes no
Current Address Street/Apt # (if applicable)
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Current address City:
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Current Address Zip Code:
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Community College Email Address:
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Personal Email Address:
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Cell Phone Number:
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Country of Citizenship:
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US Permanent Resident Alien Number:
(if applicable)
If you are a citizen of a country other than the United States you must have a visa to work in the US. Please tell us the name of this visa
US Work Visa Expiration Date:
This refers to the work visa in the previous question
How do you identify yourself?
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Hispanic or Latino. Not Hispanic or Latino
Hispanic or Latino is defined for these purposes as; A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
Race:
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American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White More than one
1, American Indian or Alaskan Native. (A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.) 2, Asian. (A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.) 3, Black or African American. (A person having origins in any of the black racial groups or Africa. Terms such as "Haitian" or "Negro" can be used in addition to "Black or African American.") 4, Native Hawaiian or Other Pacific Islander. (A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.) 5, White. (A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.)
If you selected more than one race, please select all that apply:
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Cuba Mexico Puerto Rico South or Central America or other Spanish culture or origin
Are you a veteran?
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Yes
No
Do you receive any benefits from the following veterans benefit programs?
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Federal Dependent Education Assistance Program (Chapter 35) - for spouses and children of veterans who are 100% disabled Virginia Military Survivors & Dependent Education Program - for veterans who are 90-100% disabled and their spouses and children Other No
If selected other please explain:
Did you complete a FASFA application to determine your eligibility for financial aid?
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Yes
No
How are you paying for your education?
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Pell Grant Health Professional Student Loans (HPSL) Loans for Disadvantaged Student Program Scholarships from the U.S. Department of Health and Human Services under the Scholarship for Individuals with Exceptional Financial Need. Loan "Out of Pocket" Other
FASFA is the application that is filled out to see if you are eligible for aid. We are interested in knowing what type of aid you recieved after completing your FASFA application. If in doubt, select other and explain to us what you recieve.
If you selected other please explain:
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What was the highest level of education your parent 1 completed. For example: high school, AS/AA, BS/BA, MS/MA, PhD/MD/DDS, etc.
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What was the highest level of education your parent 2 completed. For example: high school, AS/AA, BS/BA, MS/MA, PhD/MD/DDS, etc.
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Do you have an identified disability?
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yes no don't know
Please note: Having a disability will not prevent you from participating in this program
Please share with us your thoughts on how your disability has or could impact your academic success (if at all):
Please note: Having a disability will not prevent you from participating in this program
What were the most important challenges or obstacles your family faced while you were a child or a teenager?
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What do you think will be the most important challenges or obstacles to completing your undergraduate degree?
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What is the highest level of education you have completed?
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If other, please explain:
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When did you complete that program?
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Today M-D-Y
Name and Address of Diploma Granting Institution:
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Are you currently enrolled in a community college?
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yes no
We're sorry, our Summer research program is only available to students currently enrolled in community college.
Name of Current Community College:
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Community College Campus:
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Date first enrolled at current community college:
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Today M-D-Y
Current Curriculum:
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How many credits have you completed (as of January 1st)?
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How many credits do you plan to complete in the Spring 2022 semester?
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How many credits did you attempt Fall 2021?
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How many credits did you successfully complete Fall 2021?
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What was your GPA as of January 1st 2022?
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Please check off the courses you have completed at community college so far (as of Jan 1st 2022):
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Please list the course number and names of any additional courses you feel are important:
Please list the courses you are taking this semester (Spring 2022):
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When (semester and year) do you expect to complete your AA or AS degree?
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Today M-D-Y
Have you taken the SAT or ACT ?
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Yes SAT
Yes ACT
Yes Both
No
Please note: completion of the SAT or ACT is not a requirement for this program
SAT: Overall score and percentile
SAT: Math score and percentile
SAT: Critical Reading score and percentile
SAT: Writing score and percentile
ACT: Overall score and percentile
ACT: English score and percentile
ACT: Math score and percentile
ACT: Reading score and percentile
ACT: Science Reasoning score and percentile
Please list any certifications you may have earned.
Please list any honors or awards you may have received:
Please describe any research-related activities in which you may have participated, now or in the past
Please note: Research experience is not a requirement for eligibility into our summer program
Do you currently hold a paying job?
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Yes
No
Name of employer
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Name of company
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What is your position?
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ie: Server, Host, Cashier, Delivery Driver, Data Entry....
How many hours do you work in a typical week?
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Have you ever held a paying job?
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Yes
No
Please note: This is not a requirement of the program to have previously held a paying job
Please tell us about any jobs you may have held in the past (please include rough dates).
We're interested in all work experience not just science related!
Please tell us about any volunteer activities you may have participated now or in the past.
What do you like to do for fun? hobbies, interests, activities, sports etc
Please provide an example of a time when you failed or did not perform as you had hoped. What did you learn from this experience and what actions did you take to move forward with your life?
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What are your educational plans for the next year?
For example, do you plan to complete your Associate's degree, transfer to a 4 year college/ university or other program, or do something else?
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There is no wrong answer!
Do you plan to transfer to a 4-year college or university?
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yes no I don't know yet
Do you aspire to continue your education after completing a B.S?
yes no I don't know yet
Do you hope to go to Medical School?
yes no I don't know yet
Do you hope to go to pharmacy, dentistry, nursing, or other professional health sciences program?
yes no I don't know yet
Do you hope to earn a Masters or PhD degree?
yes no I don't know yet
What are your career goals? (about 100 words!)
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Why are you interested in participating in the DTG Summer Research Program? (about 100 words!)
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What do you expect to gain from this experience? (about 100 words!)
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What do you feel you have to offer this program? (about 100 words)
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Did the COVID-19 pandemic present you with any additional challenges or opportunities?
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Are you comfortable and committed to a full face-to-face residential experience on the VCU campus this summer?
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yes no
Are you comfortable, able, and willing to commit to a face-to-face commuter experience this summer?
* must provide value
yes no
Do you have any questions or concerns about the DTG program?
Is there anything else you would like us to know about you?
Please note:
Participants in the DTG program are required to live in a shared dorm room on the VCU campus for the duration of program.
Exceptions MAY be considered. Contact us directly on bridges@vcu.edu to discuss your situation.
Letters of recommendation:
Please provide the name, email address, and phone number of one person who can provide a letter of reference for you.
Letter of reference must be from a science or math instructor at your community college.
By the application deadline, letters of recommendation should be emailed directly to us at the following email address: bridges@vcu.edu
Science or Math Instructor:
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Instructor or Employer:
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Please email a copy of your current community college transcript to the following email address: bridges@vcu.edu
Please type your name and the word "transcript" in the subject line. For example: Joe Blogs - transcript
We will accept your unofficial transcript.
How did you learn about the DTG Program (check all that apply):
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Thank you for taking time to complete this application!
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