Application | Iowa Biosciences Academy | Department of Biology

Personal Background

First Name *

Middle Name *

Last Name *

Email *

Mailing Address *

City *

State *

Zip Code *

Daytime Phone *

Date of Birth *

Month

Day

Year

Where did you attend high school? (Name, City, State) *

Please include the name of high school, city and state.

Year in School *

Anticipated Undergraduate Graduation Date *

Major / Intended Major *

Country of Citizenship *

Students must be a U.S. citizen or permanent resident to participate in this program.

Are you a permanent resident of the US? *

Yes

Ethnicity *

Alaskan Native/American Indian

African American or Black

Asian

Hispanic or Latin(o/a)

Native Hawaiian or Other Pacific Islander

White

International (non-US-Citizen)

Unknown

I do not wish to provide this information

Check all that apply.

Please check all of the following that apply:

Have you been or are currently homeless?

Have you been or are currently in the foster care system?

Have you been or are currently eligible for a Federal Pell Grant?

Have you been eligible for the Federal Free and Reduced Lunch Program for two or more years?

Have you received support from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC)?

Has your parent(s) or legal guardian(s) completed a bachelor’s degree?

Have you grown up in a rural area?

Check all that apply.

Do you have a verifiable disability?

Yes

I do not wish to provide this information

Tell Us About Yourself

Tell us about the development of your interest in science and research. What draws you to science? *

2000 character maximum.

Tell us why you think you’d be a good fit for IBA? How will IBA support your career goals? *

2000 character maximum.

Are you currently doing research in a lab? *

Yes

If yes, who is your lab/research advisor?

How do you identify as an underrepresented or marginalized student? Share with us ways in which you are promoting diversity in your daily life. *

2000 character maximum.

Letter of Recommendation

IBA will receive a letter of recommendation in support of my application from the following science/math instructor or research advisor *

S/he will send the letter to: Iowa Biosciences Academy, The University of Iowa, 108 Biology Building, Iowa City, IA 52242 or email it to iba@uiowa.edu

IBA Information

How did you find out about the IBA program? *

If other (please explain)

Release of Information *

I agree

I do not agree

My academic standing is a factor for admission to IBA; therefore, I give IBA staff permission to obtain my transcripts. If I completed coursework at another college or university, I am responsible for submitting transcripts from that school to the University of Iowa Office of Admissions, and IBA may obtain a copy of those transcripts from Admissions.

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