Student Trainee Request Webform
All requests must be approved by the Office of Pediatric Education and the School of Medicine Human Resources Group (HRG). Submit this request AT LEAST FOUR WEEKS IN ADVANCE of the proposed start date.
Note: Trainees must be at least 16 years of age to train in a lab. Trainees are not permitted to observe in clinical settings. Trainees must be supervised at all times by a Faculty Sponsor/Supervisor. A complete application is required for each individual Student Trainee.
Submitter's Full Name
Faculty Sponsor Full Name
Faculty Sponsor Email
Allergy & Immunology
Human Gene Therapy
Medical Biochemical Genetics
Student Trainee Information
Student's Full Name
Student's Date of Birth
Note: Trainees must be at least 16 years of age to train in a lab.
The trainee will be at least 18 years of age at the start of the training experience
Student's Year in School
High School Student
Not currently enrolled in school
Will the Student Trainee receive academic credit for the training?
If yes, attach authorization/recommendation letter from student's school or proof of course registration.
Upload completed and signed forms:
1. Student Trainee Request Form (Packet 1)
2. Student Trainee Required Forms (Packet 2)
3. Copy of Student's Medical Insurance Card
4. If Student is seeking course credit, submit letter of recommendation and proof of course enrollment/description.
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