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BIOMEDICAL ENGINEERING SUMMER INTERNSHIP PROGRAM
OMB No. 0925-0299
Expiration Date 9/30/2012
Respondent Burden
PROGRAM APPLICATION
Instructions: Before you begin, you may want to review some helpful hints on using this electronic form and our privacy statement.
If you wish to MODIFY a submitted application, please go to the BESIP home page and click on the link for Modify Existing Application.
A list of projects and mentors for previous BESIP Programs can be found at the BESIP web site. Mentors and projects for Summer 2011
will be available by February for the Summer 2011 program.

Eligibility Criteria:
1. Eligibility for the BESIP program can be found at the BESIP web site. The BESIP program is for undergraduate bioengineering
students only who have completed their junior level requirements by the time the 2011 summer program starts and will be returning
to their undergraduate school for at least one additional semester after the 2011 BESIP program. No majors other than
bioengineering and biomedical engineering will be accepted into the program.
2. Candidates must be U.S. citizens or permanent residents, and be attending a college or university in the United States.
Application Tips:
This form has recently been revised to allow you to save a partially completed application. To take advantage of this feature, please
proceed as follows:
Enter as much information into the form as you would like.
Press "Save Partial Application & Quit" to save the information you have entered thus far, and return later to complete your
application.
When you first submit your partial application, you will automatically receive a confirmation e-mail containing login information
and instructions for accessing the online tool that allows you to review, modify, and complete your application.
Once you complete your application, press "Preview Completed Application." You will be taken to a page displaying the information
you have provided. To submit your completed application, you must click the "Save" button on the Preview page.
IMPORTANT NOTE: All fields on your application must be completed by February 11, 2011 (midnight, Eastern Standard Time).
Applications that are incomplete after the 2/11 deadline will not receive further consideration.
1. Please read "Application Information" before beginning to complete your online application.
2. Be sure that the e-mail addresses you provide for your references are accurate. Incorrect e-mail addresses will delay the
processing of your application and could result in your application's not receiving full consideration.
3. Please note that this form accepts plain text inputs only. This means that special characters and formatting such as bullets,
"smart quotes," bold or italic fonts, Greek letters, etc., will be lost or altered. To ensure your data appears as you intend it to,
compose your inputs to the longer fields on this form using a plain text editor (e.g., Notepad, for PC users, or TextEdit, for Mac

users). In place of special formatting, you will need to rely on the use of capital letters, white space, asterisks, and other standard
keyboard characters.
4. Proofread your application thoroughly for accuracy and completeness; false or inaccurate information may be grounds for denying
your candidacy or removing you from the program.
5. Complete your application as soon as possible and encourage your references to submit their letters promptly using the electronic
system.
6. The deadline for receipt of completed applications is February 11, 2011 (midnight, Eastern Standard Time). Applications that are
incomplete after the 2/11 deadline will not receive further consideration. Be sure that your letters of recommendation are
submitted online by February 11, 2011.
7. Sections 7, 8, and 9 of this application are not necessary when applying to the BESIP program but may be optionally filled out if
you wish this application to be also considered later for the regular Summer Internship Program (SIP) in the event that you are not
selected for BESIP.
Indicates a required field.

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1. Personal Information
You must enter this information if you wish to save your application.
Name:

Mr.
First

Month/Day of Birth:

/

MI

Last

(mm/dd)

Permanent Home Phone:

Format: (999) 999-9999
Format: [email protected]

E-mail Address:
To obtain a free e-mail account, click here
Password:

Personal Information - Continued
Permanent Address:

City:
State:

(DC for Washington D.C.)

Zip Code:
US Citizen
If Permanent Resident:
Citizenship Status:
Country of Citizenship

Alien Registration No.

Previous Research Experience at NIH (Programs
completed):

None

Relative at NIH:

Yes

No

If yes, relative employed by:

NIH summer training occurs on several sites including the main campus in Bethesda, MD. To help our investigators,
please indicate ALL locations where you would be willing to train this summer.
Baltimore, MD (most NIA labs and all NIDA labs)
Bethesda, MD (main NIH campus)
Detroit, MI (limited positions in NICHD)
Frederick, MD (some NCI labs)
Hamilton, MT (limited positions in NIAID)
Phoenix, AZ (limited positions in NIDDK)
Research Triangle Park (Raleigh/Durham), NC (NIEHS only)

2. Academic Information
School Name:
Preferred Mailing Address:

City:
State:

(DC for Washington D.C.)

Zip Code:
Preferred Phone Number:

Format: (999) 999-9999

Current Education Level:
Year at Current Level:
Anticipated Graduation Date:
Current Cumulative GPA:
School Grading Scale:
Note: If you select 'Other', please explain in Section 3, Coursework and Grades. Be sure
to describe your school's grading scale and your current cumulative average relative to
that scale.
Total Credit Hours
(by the end of this semester):
Academic Major:

or

3. Coursework and Grades Include courses that you are currently enrolled in.

4. CV/Resume
Copy and paste a plain text version of your curriculum vitae into this space. Minor reformatting may be necessary. Include education,
relevant research experience, scientific publications, honors and awards, etc.

5. References
Once you submit your completed application, an e-mail request for a letter of recommendation will automatically be sent to each of
the following individuals:
Reference 1:
Name:

Mr.
First

MI

Last

Address:
Phone:
E-mail:

Format: [email protected]

Reference 2:
Name:

Mr.
First

MI

Last

Address:
Phone:
E-mail:

Format: [email protected]

6. Cover Letter: Describe your research interests, career goals, and reasons for applying for training at the NIH; be certain that your
cover letter is specific for this particular program.

Summer Internship Program (SIP)
Section 7, 8 and 9 apply to the Summer Internship Program (SIP). In the event that you are not selected for BESIP, your application will
be forwarded to the SIP program automatically. At that time, you must direct any inquires about summer positions to the SIP Program
Coordinator in the Office of Intramural Training & Education and not the BESIP Program Director.
To help you define your research interests and make the best choice -- for you -- of a summer training opportunity in SIP, you can
select RESEARCH INTERESTS as follows:
Areas of Scientific Interest: Up to three (3) choices from the drop-down list
Medical Entity/Disease: Up to three (3) choices from the drop-down list
There are no wrong choices: you may select only 1 category or as many as 6. Choose what best reflects your interests and abilities.
Investigators at NIH will then search the system according to their needs and look for the best match of your talents and their
research projects for the summer.

7. Areas of Scientific Interest:
1.
2.
3.

8. Medical Entity/Disease:
1.
2.
3.

9. I would like to be considered for the following Institute/Center:

Notice to all applicants:
It is your responsibility to ensure that all of the above information is correct. False or inaccurate information contained in this
application may be grounds for denying your candidacy or removing you from the program.
Save Partial Application & Quit

Preview Completed Application

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Burden Disclosure Statement for Applicants –
Public reporting burden for this collection of information is estimated to average 45-minutes for
the application and 45-minutes for the supplemental material per response, including the time
for reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing
this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda,
MD 20892-7974, ATTN: PRA (0925-0299). Do not return the completed form to this address.

Burden Disclosure Statement for References –
Public reporting burden for this collection of information is estimated to average 15-minutes per
response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to,
a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705
Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0299). Do not
return the completed form to this address.