Continued funding for our programs depends on our ability to provide complete and accurate demographic information for reporting purposes to funding agencies. Your name will not be associated with your responses when reporting this information externally. However, the information marked with a red asterisk (
*) may be used to verify eligibility for the internship.
Which of the following represents your status in the US?
*
I am a US citizen
I am a US permanent resident
I am an international student
None of the above
What is your gender identity?
Woman
Man
I identify as:
Decline to state
Are you of Hispanic/Latinx origin?
*
Yes
No
Unknown
Which of the following best describes your race? You may hover over each term for a definition. Select all that apply. For example, if you
are of Hispanic/Latinx origin, you may be a mix of American Indian/Alaska Native as well as Caucasian. If you are
not of Hispanic/Latinx origin, you may still be a mix of American Indian/Alaska Native as well as Caucasian. You may select "Unknown" if your race is unknown to you.
*
American Indian/Alaska Native
Includes all indigenous people of North, Central, and South America
Asian
Includes all indigenous people of East Asia, Southeast Asia, and the Indian subcontinent
Black
Includes all indigenous people of Africa
Hawaiian/Pacific Islander
Includes all indigenous people of Pacific Islands, including Hawaii, Guam, Fiji, Philippines, Tonga, and Samoa
Caucasian
Includes all indigenous people of Europe and Middle Eastern countries, including Spain, Italy, and Portugal
Unknown
Your ancestry is unknown to you
What language(s) did you grow up speaking in your home?
*
Do you have any disabilities, defined as a physical or mental impairment that substantially limits one or more major life activities?
*
Yes
No
Are you a veteran of the US Armed Forces?
*
Yes
No
Which of the following programs have you ever participated in?
*
Advancement via Individual Determination (AVID)
Apprentice Researchers (AR)
California Alliance for Minority Participation (CAMP)
Educational Opportunity Program (EOP)
Early Undergraduate Research Experience and Knowledge Acquisition (EUREKA)
Gorman Scholars Program
Maximizing Access to Research Careers (MARC)
McNair Scholars Program
Mathematics, Engineering, and Science Achievement (MESA)
Problem-based Initiatives for Powerful Engagement and Learning in Naval Engineering and Science (PIPELINES)
Quantum Foundry Undergraduate Research Program
Summer Institute in Mathematics and Science (SIMS)
School for Scientific Thought (SST)
Smithsonian Scholars Program
University of California Leadership Excellence through Advanced Degrees (UC LEADS)
I have not participated in any of the above programs.
Do you qualify for a free or reduced lunch?
Yes
No
Unknown
Decline to state
Are you from a single parent home?
*
Yes
No
Have you ever been in the foster care system?
*
Yes
No
Please provide the education level of the parents/guardians who you have lived with. You can enter up to 4 by clicking "Add another parent/guardian".
*
-
Education Level of Parent/Guardian #1
-
Education Level of Parent/Guardian #2
-
Education Level of Parent/Guardian #3
-
Education Level of Parent/Guardian #4
Will you be the first generation in your family to earn a bachelor's degree?
* (If your parents/guardians did not earn a bachelor's degree, then you are first-generation.)
Yes
No
Unknown