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NCCU Partners Public Health Application
NCCU Partners Public Health Application
The application is now open! Deadline to submit applications is February 24, 2023
.
Personal Information
Name
*
First
Middle
Last
Email address
*
Phone number
*
Current mailing address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Permanent mailing address (if different from above)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Race/Ethnicity
*
More than one can be chosen.
African American
Asian/Pacific American
Latino/Hispanic
Native American/American Indian
White/Caucasian
Other
Please indicate tribal enrollment
*
Please indicate ethnicity
*
Gender
*
Female
Male
Non-binary
Transgender
Prefer to self-describe
Prefer not to say
Please describe your gender identity or expression:
Citizenship/Residency
*
Applicants must be U.S. Citizens or Permanent Residents (Green Card holder)
U.S. Citizen
Permanent Resident
Do you have a valid N.C. driver's license?
*
Yes
No, but I have a valid license in another state
No, I do not have a driver's license
Your Banner ID number
*
For financial purposes only
Education
Status at time of application
*
Freshman
Sophomore
Junior
Expected graduation date
*
Current overall GPA
*
Major(s)
*
Minor(s)
Relevant college courses
*
e.g. Biology, chemistry, math, and/or public health courses. Please separate entries with a comma.
Letters of Recommendation
Please enter the contact information for the two faculty members who are writing your letters of recommendation. They will receive an email with instructions on how to submit their reference letter.
Name of faculty reference #1
*
First
Last
Department
*
Email
*
Phone
Name of faculty reference #2
*
First
Last
Department
*
Email
*
Phone
Application Documents
Upload your current transcript(s)
*
Drop files here or
Select files
Max. file size: 98 MB.
Upload your personal statement
*
Compose a 1-2 page personal statement explaining why you are applying for this internship, your research experience, and your educational and career goals. Statements should be typed in 12-point font, single spaced, with 1-inch margins.
Max. file size: 98 MB.
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