Application Form: High School Student Internship Program

Keck Graduate Institute (a member of the Claremont Colleges)

Application Deadline: May 5, 2017 Program Dates: June 26 – August 4, 2017 (flexible)

Your Contact Information:

First Name: Last name:

e-mail address: Phone #:

Mailing Address:

Street:

City: State: Zip:

Your School’s Contact Information:

Name of High School: School District:

Name and contact information of a contact person at your school’s office (for administrative questions):

First Name: Last name:

e-mail address: Phone #:

Mailing Address of High School:

Street:

City: State: Zip:

Education:

Current Grade Level (Fr/So/Jr/Sr): Current GPA:

Please list the high school science and math classes you have taken or are currently taking (indicate if AP), plus the grade obtained in each class (for current classes, state: in progress). We also ask for you to submit an official transcript.

Please describe any other science related activities you have engaged in and any relevant technical skills you may have (not required for program participation):

Interests:

Please describe briefly why you want to participate in this program, which general scientific areas (biology, chemistry, physics/engineering, mathematics, computer sciences) and / or research topics are of most interest to you. For a listing of research projects offered through our SURE program to undergraduate student interns, go to www.kgi.edu, then browse to Academic programs – Summer Programs – SURE and click on Project Descriptions on the left. Please note: not all SURE program research projects are available to high school student interns! We will do our best to match you up with a suitable mentor based on your preferences and based on which projects are suitable for and open to high school students.

Scheduling:

The summer high school internship program runs in parallel with our Summer Undergraduate Research program. You may intern at KGI between June 26 – August 4, 2017, for the entire period or a fraction thereof, either full time (40h/week) or part time (minimum 10h/week).

I can start my internship on: I can end my internship on:

I can work for: hours per week.

Full time hours are Mo-Fri, 9am-6pm with a 1h lunch break. If you wish to work part time, please indicate your preferred schedule. Please also list any other scheduling restrictions (i.e. do you need to take time off during your internship? If yes, indicated dates and reason):

Signature: Date:

Other application materials required: / Please send ALL application materials in ONE mailing to: / Questions? Contact:
· Official transcript in a sealed envelope
· A recommendation letter from one of your high school science teachers, in a sealed envelope with the signature of your recommender across the seal. / High School Internship Program
Attn.: Dr. Kiana Aran
Keck Graduate Institute
535 Watson Drive
Claremont, CA 91711 / Dr. Kiana Aran
Assistant Professor
Internship Program Coordinator

(909) 607-8512