Northwestern University Pulmonary and Critical Care Medicine Kimberly Querrey Summer Research Program Application

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The question below applies to determining disadvantaged status. For information about each item please see the Helpful Links section immediately following this question. Please check the box next to each situation that applies to you:

The question below applies to determining disadvantaged status. For information about each item please see the Helpful Links section immediately following this question. Please check the box next to each situation that applies to you: Were or currently are homeless, as defined by the McKinney-Vento Homeless Assistance Act Were or currently are in the foster care system, as defined by the Administration for Children and Families: The Title IV - E Foster Care Program or the The John H. Chafee Foster Care Program for Successful Transition to Adulthood (Chafee Program) Were eligible for the Federal Free and Reduced Lunch Program for two or more years Have/had no parents or legal guardians who completed a bachelor’s degree Were or currently are eligible for Federal Pell grants Received support from the Special Supplemental Nutrition Program for Women, Infants and Children as a parent or child Grew up in one of the following areas: a) a U.S. rural area, as designated by the Health Resources and Services Administration Rural Health Grants Eligibility Analyzer, or b) a Centers for Medicare and Medicaid Services-designated Low-Income and Health Professional Shortage Areas (qualifying zip codes are included in the file) Family Income at or below the published levels based on household size None of the above apply to me

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Please check one I am a US Citizen or Permanent Resident. I posses a valid Employment Authorization Document (EAD Card - please indicate expiration date and any restrictions below) Other - (Please indicate visa type, sponsor, start and end dates, and country of citizenship in the space below)

Two letters of recommendation from teachers, mentors, or advisors will needed to complete your application. Your most recent transcripts are also required. Please have your letters and transcripts sent to PULMSRP@northwestern.edu with your name in the subject line. We cannot accept letters and transcripts submitted by the applicant. This is not required if you were previously accepted into the program and are applying for your second year.

Two letters of recommendation from teachers, mentors, or advisors will needed to complete your application. Your most recent transcripts are also required. Please have your letters and transcripts sent to PULMSRP@northwestern.edu with your name in the subject line. We cannot accept letters and transcripts submitted by the applicant. This is not required if you were previously accepted into the program and are applying for your second year. I acknowledge my application will not be complete until 2 letters of recommendation and my current transcripts are received. I am applying as a returning participant and they are not required.

The Kimberly Querrey Summer Research Program does not provide or recommend housing. Interns are responsible for obtaining and paying their own housing costs.

The Kimberly Querrey Summer Research Program does not provide or pay for parking or other transportation costs. Interns are responsible for getting themselves to and from the downtown Chicago campus.

The Kimberly Querrey Summer Research Program does not provide or recommend housing. Interns are responsible for obtaining and paying their own housing costs.

The Kimberly Querrey Summer Research Program does not provide or pay for parking or other transportation costs. Interns are responsible for getting themselves to and from the downtown Chicago campus. I acknowledge that I am responsible for my own transportation and housing arrangements.

All participants in the Kimberly Querrey Summer Research Program must be fully vaccinated against COVID-19. If you are selected to participate in the program you will be asked to provide proof of vaccination.

All participants in the Kimberly Querrey Summer Research Program must be fully vaccinated against COVID-19. If you are selected to participate in the program you will be asked to provide proof of vaccination. I acknowledge that if I am selected to participate in the program I will provide proof of vaccination.

Northwestern University Pulmonary and Critical Care Medicine Kimberly Querrey Summer Research Program Application

Northwestern University Pulmonary and Critical Care Medicine Kimberly Querrey Summer Research Program Application

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Required for all high school students and anyone under the age of 18.

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