Form page 1
Personal Information:
Name
Last, First Middle
Email:
DOB
month/day/year
Current Phone
Current Address
Permanent Address
Emergency
Contact
Recommendation letter(s) provided by
College/University Education:
Name of School
City, State
Calendar Years Attended
Course of Study/Major
Year Diploma Anticipated
Total GPA
High School Education:
Name of School
City, State
Calendar Years Attended
Course of Study
(if applicable)
Year Diploma Awarded
or anticipated
Total GPA
Spark Application ESSay
Form page 2
Spark Application Form
Demographics (optional):
Race:
Indicate with an X in the column that best fits you. If you are of mixed race or ethnicity, indicate multiple Xs or specify in the “other” cell / American Indian/Alaskan Native
Black/African American
Native Hawaiian /Pacific Islander
Asian
White
Other: <type or paste here>
Ethnicity: / Hispanic/Latino
Not Hispanic/Latino
School and Community Activities:
Awards and Honors
Research Experience
Other Activities or Experience
Additional Education:
Name of School
City, State
Calendar Years Attended
Course of Study/Major
Diploma/Certificate Awarded
Total GPA
Important Information for Applicants
Eligibility: This program is for college/university undergraduates with a strong preference for students who have completed 2 or 3 years of study who have had advanced coursework and laboratory experience. If you will have graduated from a college or university by May, do not apply, you are past eligibility. If you will not have graduated high school by June, do not apply - you are not yet eligible. If you are a high school student with a strong interest in gaining experience, Moffitt has a Teenage Volunteer Program. The application process is different so visit the to find out more information.
Admission: Students admitted to the program will provide a local address (where they will be living during the summer) and a social security number. They will be subjected to a criminal background check, standard medical tests appropriate for their work area (TB for example) and a test for the use of illegal drugs. Student will not be paid or allowed to train in the labsuntil these admission requirements are met.
Instructions for Completion of the Application Form:
Form page 1:
This page is largely self-explanatory. If you have attended multiple universities or high schools please indicate the most recent on page 1 and others on page 3. Most contact will be made by email so it is important that you monitor regularlythe email address you supply. Indicate your expected date of graduation. You may also indicate the colleges or universities to which you have been admitted and the planned course of study. Alternatively, simply indicate that this section is not applicable. If the first page spills over onto a second page, please delete any unnecessary blank lines. Provision of a social security number will be required immediately upon acceptance into the program.
Form page 2:
You will type or paste your essay onto this form. It is best to paste in as text only. The essay should not exceed this one page. The essay should describe your research interests and tell us why you consider yourself well-prepared for participation.
Form page 3 (continuation page):
You will type (or paste in) any addition information that you feel is relevant to your application here. The cells will expand to accommodate as much text as you need. It is best to paste in as text only.
Submitting the application:
The completed application will contain:
• A completed application form in Word format submitted by email to .
• At least one letter of recommendation from a person with whom you share an academic relationship (see below)
• Most relevant academic transcripts (high school transcripts unless one full year of college has been completed) Please submit electronically, if possible. If your institution provides electronic transcripts, use the contact information below and the email address .
Please mail paper application materials to:
Evelyn Rivera-Miranda
MRC-4East
Office ofResearch Education
MoffittCancerCenter
12902 Magnolia Drive
Tampa, FL33612
All application materials must be received by February 15th
Letters of recommendation
Letters of recommendation should be no more than two-pages and provided on institutional letterhead. It is the applicant’s responsibility to see that letters arrive at Moffitt by the due date. Letters may also be provided by email, if from the individual’s professional address to . The subject line should read “SPARK Recommendation for LastName, FirstName”. Letters of recommendation should be from a person with whom you share an academic relationship. At least one, but no more than three letters may be provided. Letters should describe the writer’s relationship with the candidate and should address the applicant’s personal character and potential as a leader in cancer researcher. Since most applicants have outstanding academic credentials, these letters are very important to the selection committee to make distinctions among the candidates.
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