2025 CoSIBS Application

2025 CoSIBS Application

First Name*

Last Name*

Email Address*

Alternative Email Address

Street*

City*

State*

Select

Country*

Please indicate your sex*

This information is used for NIH reporting purposes.

Female

Male

Intersex

Prefer not to respond

Date of Birth (MM/DD/YYYY)*

Ethnicity*

Hispanic

Non-Hispanic

Prefer not to answer

NIH encourages institutions to diversify their student populations to enhance the participation of individuals from groups that are underrepresented in the biomedical, clinical, behavioral and social sciences (check all that apply, see below for additional information)

Individuals with disabilities, who are defined as those with a physical or mental impairment that substantially limits one or more major life activities, as described in the Americans with Disabilities Act of 1990, as amended.

Individuals from disadvantaged backgrounds, defined as those who meet two or more of the following criteria:

1. Were or currently are homeless, as defined by the McKinney-Vento Homeless Assistance Act

2. Were or currently are in the foster care system, as defined by the Administration for Children and Families

3. Were eligible for the Federal Free and Reduced Lunch Program for two or more years

4. Have/had no parents or legal guardians who completed a bachelor’s degree

5. Were or currently are eligible for Federal Pell grants

6. Received support from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) as a parent or child

7. Grew up in a) a U.S. rural area, as designated by the Health Resources and Services Administration (HRSA) or b) a Centers for Medicare and Medicaid Services-designated Low-Income and Health Professional Shortage Area

I am included in one of the following racial and ethnic groups: Blacks or African Americans, Hispanics or Latinos, American Indians or Alaska Natives, Native Hawaiians and other Pacific Islanders

I am the first generation in my family to attend college

I am from a financially disadvantaged family

I have a disability that substantially limits one or more major life activities

N/A

US Citizen / resident*

US citizen

US permanent resident

Current college or university*

College/University State*

Select

Major field of study*

Minor field of study (if applicable)

Full name of Recommender*

Email of Recommender*

Institution or workplace of person writing letter*

Additional Documents Needed Below:

You will need to upload two documents.

Document 1: Personal statement to describe your background and interests, your educational goals, and why you are interested in the CoSIBS program.

Document 2: An electronic copy of your all transcripts from universities you have attended. This can be official or unofficial as long as the institution name is on the document. PDF is preferred.

Please have all documents ready prior to completing the application.

Once you submit your application, an automatic request for a reference letter will be sent to the recommdender email provided.

Thank you,

CoSIBS Team

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