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Required format:

2019 Knight Scholars Program Application

This application and all supplemental materials MUST be submitted online by 11:59 PM (PST) on April 5th, 2019. Please review all of the application instructions thoroughly. Only completed applications submitted by the deadline will be reviewed. Selection and notifications will take place in mid-April.

Please have all information listed below prepared prior to starting application. You cannot save work.

Eligibility Requirements:

Must be entering 10^th grade or higher in Fall 2019. Preference is given to 9^th and 10^th grade students.

Enrolled in an Oregon high school in Fall 2019. Preference given to students attending one of the following public schools:
- Woodburn High School
- Jefferson High School
- Culver High School
- Madras High School
- Chiloquin Jr/Sr High School
3.0 GPA or higher and must have taken at least one science class, preferably biology
U.S. citizen, permanent U.S. resident, or DACA (Deferred Action for Childhood Arrivals) students are eligible. A DACA applicant must have an employment authorization card via USCIS.

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Thank you for your interest in the Knight Cancer Institute 2019 Knight Scholars Program.

To complete this application, you will need the following:

A completed application form
Unofficial transcripts (if selected for the Knight Scholars Program, official transcripts will be required)
Two Essays
One letter of recommendation

Please send your recommenders to the link below for submission of their letters of recommendation.

www.ohsu.edu/knightscholars

The application and all supplemental materials should be submitted online by 11:59 PM (PST) on Monday, April 5th, 2019

Recommendation Letters are due

11:59 PM (PST) on Monday, April 5th, 2019

Please review OHSU's Code of Conduct page

http://www.ohsu.edu/xd/about/services/integrity/policies/upload/2011OHSU-Code-of-Conduct.pdf

Contact Information

3181 SW Sam Jackson Park Road

Portland, OR 97239

Mail Code: KR-ADM

Telephone: 503-418-9698

Email: KnightScholars@ohsu.edu

Last name

* must provide value

First name

* must provide value

Current mailing address

* must provide value

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Permanent mailing address

* must provide value

Same As Above

Other

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Permanent mailing address

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Primary phone number

* must provide value

Alternate phone number

E-mail address that you check frequently.

This will be used as the primary method of contact during the application process, including for time-sensitive matters.

* must provide value

Date of Birth (MM-DD-YYYY)

* must provide value

M-D-Y

How old will you be at the start of the program (July 14, 2019)?

* must provide value

Grade level in Fall, 2019:

* must provide value

Name of your school:

* must provide value

Please describe the reason you would like to participate in this program and what you are hoping to gain from this experience.

(No word limit, minimum of two paragraphs -this will be the primary way that we will be evaluating your application.)

* must provide value

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Tell us about one of your favorite science or math experiences thus far (it could be a class, camp, program, science fair, or something that raised your interest):

* must provide value

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This program includes research opportunities over future summers. Please indicate your level of interest in participating in research training beyond this 7 day experience.

* must provide value

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Unofficial transcript - we want to review the classes you have taken in the past 1-2 years and the grades you received in those classes. Please include your GPA (Grade Point Average), if known.

* must provide value

Upload file

Add another transcript?

Yes

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Upload second transcript here.

Upload file

One letter of recommendation - Please include a letter of recommendation from a teacher, community leader, coach, counselor, or someone who can speak about your curiosity, problem-solving abilities, and perseverance.

Letter of recommendation writer contact information:

Name:

* must provide value

How they know you:

* must provide value

Phone:

* must provide value

Email address:

* must provide value

(Letter writer will upload document separately. Letters of recommendation should be received by April 1.)

Parent/Guardian 1 education level

* must provide value

High School

GED

Some College

College Graduate

Other

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If other, please specify:

Parent/Guardian 2 education level:

High School

GED

Some College

College Graduate

Other

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If other, please specify:

Will you be a first generation college student (i.e. the first person in your family to attend college)?

* must provide value

Yes

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Have you ever lived or attended school in a rural area (population of 9,999 or less)?

* must provide value

Yes

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If yes, what school and location:

Are you fluent in a language that is not English?

* must provide value

Yes

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If so, specify the language(s):

All students are welcome in the Knight Scholars Program. The Knight Scholars Program is funded by the National Institutes of Health (NIH) with the goal of increasing diversity in cancer research, a component of biomedical research. It is our goal to recruit and train diverse students who may one day become biomedical researchers. The NIH considers three groups underrepresented in biomedical sciences:

"1) racial and ethnic groups comprising American Indians or Alaska Natives, Blacks or African Americans, Native Hawaiians or Other Pacific Islanders as well as Hispanics or Latinos;

2) individuals with disabilities; and

3) individuals from disadvantaged backgrounds such as those from low-income families or individuals who come from a social, cultural, or educational environment such as rural or inner-city environments which demonstrably and recently directly inhibited the individual from obtaining the knowledge, skills, and abilities necessary to develop and participate in a research career."

These demographic questions are intended to help us better recruit diverse students into the Knight Scholars Program. You may decline to answer any of these questions until admission to the Knight Scholars Program.

In selecting students for the Knight Scholars Program, additional weight will be given to candidates who are from diverse backgrounds.

Gender

What pronouns should we use when contacting you?
(e.g., he/him, she/her, they/them):

What is your race and ethnicity?
(please select all that apply)

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

Hispanic of any race

White

Other

Prefer not to answer

If other, please specify

Do you have a disability?
Disabilities may be physical, learning, medical, or developmental.

Yes

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What disability accommodations will you need during your time with the Knight Scholars program?

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Would you characterize yourself as an individual from a disadvantaged background?

* must provide value

Yes

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If yes, please describe briefly.

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Please describe anything else you'd like us to know :
(optional)

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I agree to participate in the Knight Scholars Program for the ENTIRE duration (Sunday, July 14, 2019 - Saturday, July 20, 2019)

* must provide value

Yes, I agree to participate in the 2019 Knight Scholars Program for the entire duration (Sunday, July 14, 2019 - Saturday, July 20, 2019).

No, I do not agree.

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I agree to participate in the research study being conducted as part of the Knight Scholars Program. Evaluation includes surveys and interviews about your experiences with the program. The NIH asks that we track participants for up to 10 years after participating in the program to understand how academic goals and progress may be impacted by the program.

As part of this agreement, I will keep my contact information up to date with the Knight Scholars Program. and will participate in evaluation for up to 10 years.

* must provide value

Yes, I agree to participate in the research study being conducted as part of the Knight Scholars Program.

No, I do not agree.

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I understand that upon acceptance to the Knight Scholars Program, OHSU will not issue any stipend payment until the required paperwork and documents are provided.

* must provide value

Yes, I understand that upon acceptance to the Knight Scholars Program, OHSU will not issue any stipend payment until the required paperwork and documents are provided.

No, I do not agree.

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I agree to all the terms and conditions of the OHSU Code of Conduct.

* must provide value

Yes, I agree to the term and conditions of the OHSU Code of Conduct.

No, I do not agree to these term and conditions.

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I understand that my participation in the Knight Scholars Program will require permission by my parent or guardian. Potential scholars may submit their application without their guardian's approval, but final acceptance into the program is conditional on their guardian granting permission to participate.

Yes, I understand and agree that my participation in the Knight Scholars Program will require permission by my parent or guardian.

No, I do not agree.

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Comment on Terms and Conditions:
(optional, if needed)

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Student signature:
(Please type your name here acknowledging the information above is truthful and accurate)

* must provide value

Date of signing:

* must provide value

M-D-Y

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