Fillable Bridges Program Application (San Diego Mesa College)

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Bridges Program Application (San Diego Mesa College)

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File type: PDF

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Bridges to the Baccalaureate Program
Undergraduate Research Training Program
Funded by the National Institutes of Health/National Institute of General Medical Sciences
Page 1 of 3
APPLICATION CHECKLIST
READ AND FOLLOW ALL INSTRUCTIONS CAREFULLY
Submit materials to:
Selection Committee
Bridges to the Baccalaureate Program
San Diego Mesa College
Mesa College Drive, B-107
San Diego, CA 92111
Please be sure to include the following materials:
1.
Application
(completed and signed). We frequently communicate with applicants by e-mail.
Provide a reliable e-mail account that you check and use often.
2.
Personal Statement
(no more than two pages). Your personal narrative is an important part
of the application process. Please address four areas. Include a description of your background
and interest in science, your transfer plans, your career goals, and why you would like to join
the Bridges program.
3.
Letters of Reference.
Submit two letters of reference to our office by people who are
qualified to evaluate your scientific and academic background. The letters may be sent by the
author to our offices directly, or you may submit copies with this application.
4.
Transcripts.
Attach copies of transcripts from other colleges or universities attended.
Unofficial transcripts are accepted for Bridges Program screening only, and must be submitted
(officially) prior to program entry.
Questions or concerns? Contact:
Edward Alexander, Ph.D., Director
Phone: (619) 388-2618
E-Mail: alexand@sdccd.edu
Jodi Corliss, M.S., Coordinator
Phone: (619) 388-2895
E-mail: jcorliss@sdccd.edu
Visit our website at
http://www.sdmesa.edu/bridges
bridges
Print Form
Email Form
Bridges to the Baccalaureate Program
Undergraduate Research Training Program
Funded by the National Institutes of Health/National Institute of General Medical Sciences
Page 2 of 3
STUDENT INFORMATION:
Today’s Date: CSID:
Name:
Address:
Home Phone: Cell Phone:
Date of Birth: Gender: Male Female
E-Mail Address:
Ethnicity:
ACADEMIC HISTORY AND TRANSFER INFORMATION:
Current cumulative GPA: # of college credits earned:
Current Major or Course of Study:
List the names of any other colleges attended:
Highest degree you expect to obtain:
Name at least two four-year colleges or universities you have considered applying to for transfer admission
(i.e. where do you plan to earn a baccalaureate degree?)
RESIDENCY/CITIZENSHIP:
Please indicate: U.S. Citizen Permanent Resident
ADDITIONAL INFORMATION:
Check box, if applicable: First-generation college student EOPS student
Mother/Guardian’s Level of Education and Occupation:
Father/Guardian’s Level of Education and Occupation:
(Select one)
(Select one)
Bridges to the Baccalaureate Program
Undergraduate Research Training Program
Funded by the National Institutes of Health/National Institute of General Medical Sciences
Page 3 of 3
Have you applied for and received financial aid?
If so, please explain current award:
List any Extracurricular or Volunteer activities:
List any clubs or organizations you joined at college or high school.
List academic honors and/or scholarships earned.
List any community service or volunteer work.
Are you presently employed?
If so, where do you work and how many hours per week?
LETTERS OF REFERENCE:
Please describe how you learned about the Bridges Program?
List the names of two individuals who have written your letters of recommendation?
CERTIFICATION
I certify that all the information provided in this application is accurate and complete, to the best of my
knowledge. The Bridges Program has my permission to contact the admissions or registrar office for
student record verifications. If selected into the SD Mesa College Bridges program I understand that
providing false information is grounds for dismissal from the program.
Student Name (printed):
Signature:__________________________________
Date:
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Bridges Program Application (San Diego Mesa College)

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Completed 22 July 2020

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