SAVING PROGRESS: You can save your progress on the application and complete later by clicking the "Save & Submit Later" button located at the very bottom of the application. Be sure to save your personal code to re-enter the application later.
First Name
* must provide value
Provide your legal name as it appears on official or government-issued documents (passports, licenses etc.)
Last Name
* must provide value
Provide your legal name as it appears on official or government-issued documents (passports, licenses etc.)
Date of Birth
* must provide value
Today M-D-Y *According to RPCI policy, persons under the age of 14 years old are not allowed to train in a research laboratory
Citizenship
* must provide value
U.S. Citizen
Permanent Resident
International
Current Grade
* must provide value
Freshman Sophomore Junior Senior
Have You Previously Applied to BHE?
* must provide value
Yes
No
Were you accepted to the program? (Students who have already completed the entire program once are not eligible to apply again.)
* must provide value
Yes
No
IMPORTANT: You are being asked to provide the following contact information for yourself and a parent/guardian (where indicated) who will sign program documents and permission forms. Be sure to include area codes with phone numbers. This information will be used to conduct correspondence during the application process.
Personal/Cell Phone Number
* must provide value
List your home phone number if you do not own a cell phone.
Personal Email
* must provide value
Retype Personal Email
* must provide value
If available
Permanent Residence: Street and Number
* must provide value
Permanent Residence: City
* must provide value
Permanent Residence: State
* must provide value
Permanent Residence: Zip Code
* must provide value
Parent/Guardian First Name
* must provide value
Parent/Guardian Last Name:
* must provide value
Parent/Guardian Phone Number
* must provide value
Parent/Guardian Email
* must provide value
Funding sources may be available that target certain populations of applicants based on being an under-represented minority or economically disadvantaged. If you believe you qualify in one or both of these categories, answer the questions in this section to apply to the available scholarships.
African American
American Indian or Alaskan Native
Asian (originating from Far East Asia, South East Asia, Indian Subcontinent)
Pacific Islander (including Fijian, Hawaiian, Samoan)
Latino (including Mexican American; not Puerto Rican)
Puerto Rican
White, Anglo, Caucasian American (non-Hispanic)
The following demographic information is requested on a voluntary basis. It is being collected for purposes of tracking demographics of the applicant pool ONLY and is NOT considered in the review of applications.
Male Female Prefer not to answer
Are you the first generation in your family to attend college?
Yes
No
Is anyone in your immediate family in a scientific or health-related profession?
Yes
No
School Name
* must provide value
School Address: City/Town
* must provide value
School Address: State
* must provide value
Current Cumulative GPA
* must provide value
Round to two decimal places. Include most recent marking period.
What scale is used to determine your grade average?
* must provide value
4.0
3.0
100%
Other
Do you have a computer that you can use during this summer program?
* must provide value
Yes
No
What virtual learning platforms have you used before and will be able to use this summer? Mark all that apply.
* must provide value
Google Classroom
Zoom
WebEx
Microsoft Teams
Select courses or course equivalents you have already completed or those you will be taking in the upcoming Spring semester.
* must provide value
AP Biology
AP Chemistry
AP Physics
Biology I
Chemistry
Physics
Other
Select any of the STEM or after school enrichment programs in which you currently participate:
Buffalo Prep
UB STEP
UB Medical STEP
P-TECH
Other
Please specify
* must provide value
Do you have any food allergies or requests?
* must provide value
Yes
No
Please specify.
* must provide value
Do you have any communication, mobility, learning, or other potential barriers to your success that we should know in order to make this program safe and accessible for you?
* must provide value
Yes
No
Please specify.
* must provide value
Would you like to request financial aid?
* must provide value
Yes
No
I am enrolled in the National School Lunch Program to receive free or reduced rate lunches.
Yes
No
Why are you interested in this program? How will it contribute to your long-term goals?
* must provide value
Give an example of how you've contributed to a team. What qualities will you bring to your BHE team this summer?
* must provide value
Activities, Volunteering Experience, Community Outreach, Jobs, etc. (Please list and describe a minimum of 3)
* must provide value
Full Name
* must provide value
Relationship to Applicant
* must provide value
Phone Number
* must provide value
Email
* must provide value
Upload Unofficial Transcript Here (PDF ONLY)
* must provide value
How did you hear about this program?
Facebook
Twitter
Previous participant
Teacher or school administrator
BHE presentation in school
Family member
Other
Yes
No
Submit
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