Summer Undergraduate Program in Immunology

Please fill out the following form and then press submit. All additional materials must be mailed to the Immunology Program Office.




Contact Information

Last Name: First Name:


Middle Name:

Summer Applying For (Year):

Mailing Address


City: State:



Address valid until (MM/YY):

Cell Phone:

Current Phone Number (if different from cell):

Email Address:

Confirm Email Address:

Permanent (Home) Mailing Address


City: State: Zip:

Phone number:



Undergraduate Institution

Students from Harvard College are encouraged to apply for the program, but will not be eligible for funding.

School: Major:


Current Year in School:

Expected Grad Date (MM/YY):


We would like to know which graduate degrees you are interested in pursuing. Please rank the following degrees 1-4 in order of your interest, 1 being most interested. If you are not interested in a particular degree please select "not interested." If there is another degree you are interested please let us know, and rank it as well.


PhD Rank: 

MD/PhD Rank: 

MD Rank: 


Masters Rank: 


Other:   Rank: 


Relevant Coursework:



Biographical Information

Gender: Male  Female 


Social Security #:

Birthdate (MM/DD/YYYY):


Are you a U.S. citizen? Yes  No 

If no, do you have permanent resident status? Yes  No 

I-551 card number:

Other citizenship (indicate country):


Ethnicity (please check all that apply):

African-American     Mexican-American     Puerto Rican    Asian    Caucasian 

Other Hispanic  (specify country)

Native Pacific Islander  (specify island)

Native American  (specify tribal affiliation)

Other  (specify)



Letters of Recommendation

Letter 1 will be sent by (name):

Letter 2 will be sent by (name):



How did you hear about the program? (Please check all that apply)

 Home University (or another school) site. Name of school: 

 Online search

 Previous Immunology Summer Participant. Name: 

 Faculty member at your institution




Personal Statement - please copy your personal statement below.



CV - please copy your CV below.


Application Information


The deadline to apply to the 2019 Summer Program is January 18, 2019.





© 2016 President and Fellows
of Harvard College