Department of Surgery and Perioperative Care

Research Affiliate & Visiting Scholar Interest Form

Last Name

First Name

Interest Form Submission Date

Email Address

Status

Institution

Where are you currently a student? If you are not currently a student, please provide the institution from which you most recently graduated.

Volunteer

Please confirm if you are interested in a volunteer research opportunity (unpaid).

Visa Sponsorship

Preferred Work Location (Local vs Remote)

Are you planning to be in Austin for some amount of time, or are you only looking to get involved remotely?

Requested Start Date

Requested End Date

Anticipated Time Commitment

Approximately how many hours per week will you be able to spend on this research?

Are you fluent in any languages other than English?

Attach CV/Resume

Drop your files here

Notes

Please add any additional notes about your availability, specific interests or skills, etc.

Send me a copy of my responses