Research Associate Internship Application

This form is to be completed in its entirety. A copy of the application form will be submitted to for review. An * indicates a field that is mandatory in order to complete the form.

Please rank your Speaking, Reading AND Writing Proficiency Level for each language other than English on a scale of 1-5 (1 = Poor, 2 = Needs Improvement 3 = Average/Passing, 4 = Good 5 = Excellent). For example: Spanish (Speaking) - 5
Please discuss in 200-350 words why you are interested in joining the Research Associate Internship program. What can you contribute to this program and what do you hope to gain?
Files must be less than 10 MB.
Allowed file types: pdf doc docx.
Please upload your current Curriculum Vitae(CV) in PDF form. A CV is a detailed account of your education, accomplishments, work experience, publications, etc.
Files must be less than 10 MB.
Allowed file types: pdf doc docx.
Please submit a passport sized photo of yourself.
Files must be less than 20 MB.
Allowed file types: gif jpg jpeg png bmp tif pict.
Please provide your availability for the semester(s) you are applying for the internship by uploading the completed form you downloaded from the Research Associate Internship's main page.
Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.
Two letters of recommendation must be sent in directly from two non-relatives and may be either mailed or e-mailed. Letters sent in directly from students will not be considered. Mailed letters must include a Letter of Recommendation Cover Sheet and be mailed in signed-and-sealed envelopes to: Michelle Shum - Program Coordinator; Ronald O. Perelman Department of Emergency Medicine; 462 First Avenue, Suite 345A New York, NY 10016. Emailed letters and their cover sheets may be sent to Michelle Shum using the following address: Please note, emailed letters must have a physical signature. Electronic signatures will NOT be accepted. Faxed letters will NOT be accepted. Please list both references' names, telephone numbers and email addresses below.