SURP 2022 Application Form

SURP Application Form

Please complete the application below. The deadline for receipt of all application materials is February 1, 2022. Students who will graduate before to June 2022 are not eligible for the program. In addition to the application, the SURP requires two letters of recommendation from faculty and copies of your transcripts. Please contact Dr. Latrina Prince at princelatrina@uams.edu with any questions.

Name * Required
First Last
Permanent Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Current Address (if different than permanent address)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Personal Email * Required
Enter Email Confirm Email
Home or Cell Phone * Required
Academic Institution * Required
Current Major/Minor * Required
Cumulative GPA * Required
Science GPA * Required
Expected date of graduation * Required
As of June 2022, I will be classified as a * Required
I am most interested in attending
Are you Hispanic or Latino? (optional)
Race (optional)
Gender (optional)
Optional: Have either of your parents (or guardians) graduated from a four-year university?
- Yes
- No
Optional: Are you a member of a disadvantaged group (factors that affect disadvantaged status could be social, economic, and/or educational)?
- Yes
- No
If you answered yes above, please explain.
Are you currently participating in a federally funded program (ex. McNair, RISE, etc.)? * Required
- Yes
- No
If you answered yes above, please list the program.
Upload transcripts
Max. file size: 74 MB.
You can upload copies of your transcripts here. You may also mail them to Dr. Latrina Prince.
What are your long-term academic and career goals? (250-500 words) * Required
Please describe any past research experiences. (250-500 words) * Required
How will the UAMS SURP help you attain your academic and career goals? (250-500 words) * Required
How did you find out about the UAMS SURP to Increase Diversity in Research? * Required
I waive my rights to view my letters of recommendation pursuant to the Family Educational Rights and Privacy Act. . * Required
- Yes
- No

SURP 2022 Application Form

SURP Application Form

ADMIN. WEST BUILDING, 300 HOOPER DRIVE, 2ND FLOOR, 1.213

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