Name* First Last Email* Primary Institution - Where are you currently enrolled?*Major*Aerospace EngineeringApplied MathematicsBiological and Agricultural EngineeringBiomedical EngineeringBioengineeringChemical EngineeringCivil and Environmental EngineeringComputer EngineeringComputer ScienceElectrical EngineeringElectronic Systems Engineering TechnologyData ScienceIndustrial DistributionIndustrial & Systems EngineeringInterdisciplinary EngineeringManufacturing & Mechanical Engineering TechnologyMaterials Science & EngineeringMechanical EngineeringMultidisciplinary Engineering Technology (Mechatronics)Nuclear EngineeringOcean EngineeringPetroleum EngineeringOtherIf Other, Please SpecifyCurrent Class YearFirst Year Undergraduate StudentSecond Year Undergraduate StudentThird Year Undergraduate StudentFourth Year Undergraduate StudentFifth Year ( Or More) Undergraduate StudentCurrent GPA (Overall)*Current GPA (Major)*Expected Graduation Date (Semester and Year e.g. Fall 2019)*Desired Campus(es) for Summer Research* Select All Texas A&M University UCLA Rice Florida International University Rank Order your desired campus(es)*Thrust* Biomarker Assays, Microfluidics, and Implantable Sensors Hand-held Sensor Devices Wearable Sensor Devices Modeling, Software, Patient Engagement, and Behavioral Change Personal Statement*Culture of Inclusion Statement*Please share how you believe your experiences and/or perspectives would contribute to advancing a culture of diversity and inclusion within PATHS-UP.Resume Upload (PDF)*Accepted file types: pdf.Unofficial Transcript (PDF)*Accepted file types: pdf.Voluntary Demographic InfoEthnicity - Choose One:*Hispanic or LatinoNot Hispanic or LatinoDo Not Wish to ProvideRace Identity - Choose One or More* American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Other Do Not Wish to Provide SexMaleFemalePrefer not to sayWill you be 18 or Older by May 1, 2021*YesNoCitizenship*US CitizenPermanent ResidentOther non-US CitizenDisability Status (Check all that apply)* Hearing Visual Mobility/Orthopedic Impairment Other None Do Not Wish to Provide Any other Disability/Allergy we would need to prepare for?
