LSAMP Application

Academic Information

Major*

Minor

Cumulative GPA*

On a 4.0 scale

Number of Credits Completed*

Honors, Scholarships and Awards Information

Please list your academic honors and scholarships, etc.

Clubs/Organizations (300 words max.)

Scholarships (300 words max.)

Honors (300 words max.)

Other (300 words max.)

Coursework

Non-UB students are required to send official academic transcripts to:

Dr. Letitia Thomas
LSAMP Program
222 Baldy Hall
Buffalo, NY 14260

UB students can upload an unofficial transcript below. Unofficial UB transcripts can be requested in the HUB Student Center

Upload Unofficial Transcript (UB students only)

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Science courses (300 words max.)

Technology courses (300 words max.)

Engineering courses (300 words max.)

Mathematics courses (300 words max.)

Resume

Please attach a resume to show your employment and extracurricular activities

Upload Resume*

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More About You

The following questions must be answered fully.

What are your research interests in science, technology, engineering and/or mathematics? (500 words max.)*

After receiving your degree in STEM, how will you work to improve the academic performance, retention, graduation and graduate school admission rates of historically underrepresented minority students (African Americans, Latino/a and Native Americans) who are pursuing degrees in STEM? (500 words max.)*

Reference

Please list the name of an individual from whom you will be requesting a reference. Provide their name and email address. Your reference will receive a link via email when you complete and submit this form.

Recommender Name*

First Name

Last Name

Recommender Email*

Recommender Title/Position*

Recommender 2 Name

First Name

Last Name

Recommender 2 Email

Recommender 2 Title/Position

Confirmations & Certifications

Please check the boxes to confirm that:*

I certify that all parts of this application packet are complete and accurate to the best of my knowledge. I understand that submission of false information may be sufficient for denial of admission. If accepted into the UB LSAMP program I will meet with Regional Project Staff, twice per semester and to attend at least two (2) SUNY LSAMP sponsored student meetings/workshops per academic year. Check All