SSI I: Biobridge 2021 for 9Th Grade GEAR-UP Jefferson County Students

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SSI I: BioBridge 2021 for 9th Grade GEAR-UP Jefferson County Students To be eligible for participation, applicants should: ▪ Currently be entering 9th grade attending a *GEAR UP Jefferson County School. ▪ Have an interest in and a demonstrated aptitude for science. ▪ Commit to being present on all days of the session. ▪ Submit a COMPLETED APPLICATION PACKET which includes: 1. The following Application Form 2. A current high school transcript 3. A letter of recommendation from a science teacher Deadline for Applications: May 21, 2021 by 5:00 pm Completed applications must be emailed to [email protected] UAB-CORD SUMMER SCIENCE INSTITUTE I BioBridge 2021 APPLICATION Requested session to attend (please check one): June 21-25________ July 26-30________ Contact Information: Applicant Name Date of Birth Mailing Address ____ City State Zip Code Telephone Number (Home) (Cell) Email Race M/F Name of Parent(s)/Guardian Mailing Address (if different) City State Zip Code Phone (Daytime) (Cell) Academic Information: 1. School that you will attend next fall and the grade you will enter: School District: 2. Scholastic awards or honors received: *Students entering 9th grade in the following schools receive a Gear Up scholarship for the entire tuition. Please check if you plan to attend one of the following schools, in the fall, below: Bessemer City High Fairfield High Prep Midfield High School Tarrant High School Clay-Chalkville High Center Point High School Fultondale High School Hueytown High School Shades Valley High McAdory High School Minor High School Pleasant Grove High Pinson Valley High I certify that the information contained in this application is correct and complete for participation in the SSI BioBridge program held at UAB-CORD June 21-25 OR July 26-30 from 9am to 3pm daily. This application must be mailed or emailed to Kevin Jarrett at [email protected] by May 21, 2021. Applicant Signature Date UAB-CORD Summer Science Institute CHSB19, 5th Floor, 933-19th Street South Birmingham, AL 35294-2041 Office Phone: 205-934-5171 [email protected] UAB Center for Community OutReach Development (CORD) Summer Programs Disclaimer: Summer Science Institute is planned to be held, in- person, in the CORD lab space on UAB Campus. If adjustments are needed to be made, due to COVID-19, the programs will be held virtually. .

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