Fillable SCHEIBEL SCHOLARSHIP Application for 2022 Awards Application deadline: (University of California, Los Angeles)

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SCHEIBEL SCHOLARSHIP Application for 2022 Awards Application deadline: (University of California, Los Angeles)

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SCHEIBEL SCHOLARSHIP
Application for 2022 Awards
Application deadline: Sunday, April 10, 2022, 11:59 PM PST
*Please note: late or incomplete applications will not be considered after this deadline*
UCLA Life Sciences Dean Tracy Johnson announces the extension of a program to fund outstanding undergraduate
Neuroscience IDP (uNSIDP) majors interested in research experience, who will be in their 3
rd
or 4
th
years in fall 2022. This
scholarship and research award program is funded through the generous gift of the estate of Professor Arnold Scheibel,
who was a long-term faculty member of the NSIDP. Students can apply for a one-year research fellowship at $10,500 for
the academic year starting in the fall of 2022 and ending in the spring of 2023 ($10,000 of which will go towards your
scholarship and $500 of which will be allocated as travel support, to be disbursed upon confirmation of registration for a
research conference during the 2022-2023 school year). Students who wish to get funding for research conducted over
the summer of 2022 can apply to receive $5,000 in funding for summer only or in addition to the 2022-2023 academic
year fellowship. Students with financial need (regardless of whether they qualify for financial aid) can apply for an
additional supplement of up to $7,500 to help cover tuition and fees.
All eligible students (uNSIDP majors in the 3
rd
or 4
th
year of the program interested in gaining hands-on research
experience) are strongly encouraged to apply. Importantly, having a current lab placement is not a requirement for
application as a suitable lab will be identified for you if needed. Past awardees are also encouraged to apply for a second
year of funding. Awards will be based on merit, interest in gaining neuroscience research experience, and impact on
career development. Please be advised that students may not hold two research awards at one time, so students
currently being funded through programs such as MARC or I
2
URP are not eligible.
To apply for the Scheibel Scholarship, first complete this form in its entirety (sections 1 – 5). Second, please upload
two separate documents to the following link:
https://compass.lifesci.ucla.edu/life-science-deans-award-for-
neuroscience-research/. Document #1 should be this form, with sections 1 – 4 filled out. Document #2 should be
your résumé/CV (containing the information requested in section 5). Very importantly, please name Document #1
“Scheibel Application - [your first and last name]” and Document #2 “Scheibel CV- [your first and last name].”
APPLICATION FORM
1. PERSONAL INFORMATION:
La
st Name: First Name:
UCLA SID:
By providing your UCLA SID number you are authorizing the uNSIDP committee to access information from you
r
s
tudent record for application purposes and during the period of the award.
Major: Minor (if any):
Email:
Cell phone or best contact phone: Text OK? Yes No
Date of matriculation to UCLA:
Overall GPA at UCLA:
Expected graduation date (quarter, year):
Highest degree objective:
PhD
Dual degree (MD/PhD or DDS/PhD or similar)
MD
Master of Science (MS)
Bachelor of Science (BS)
Other professional degree (e.g. PharmD, DVM, DDS, etc.)
Other________________________________________
Ethnic group:
Hispanic or Latino
Not Hispanic or Latino
R
acial group (check all that apply):
American Indian or Alaska native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
Other_______________________________
Are you from a socio-economically disadvantaged background and qualify for federal disadvantaged assistance
(e.g. Pell grant)? Yes No
[If applicable, please have documentation available for verification upon request.]
A
re you currently eligible to receive In-State Tuition (including AB 540)?
Yes No Not Applicable.
A
re you a transfer student? Yes No
I
f yes, what college did you transfer from? __________________________________________
Are you a student with a disability? Yes No
I
f yes, have you registered with the UCLA Center for Accessible Education (CAE)? Yes No
H
ow did you hear about this funding opportunity? (Please choose)
URC-Sciences
uNSIDP Website
Bruin Resource Center
uNSIDP Student Advisory Officer
Compass website
Other_____________________________________
2. AWARD:
Please check the award you are applying to (applicants may check only one box):
_____ 2022 Summer Research Award ($5,000)
_____ 2022 - 2023 Academic Year Award ($10,500)
_____ 2022 - 2023 Academic Year Award ($10,500) + 2022 Summer Research Award ($5,000)
_____ 2022 - 2023 Academic Year Award ($10,500) + tuition supplement ($7,500)
_____ 2022 - 2023 Academic Year Award ($10,500) + 2022 Summer Research Award ($5,000) + tuition
supplement ($7,500)
3. TRANSCRIPT(S):
P
lease authorize the uNSIDP committee to obtain your Degree Audit Report (DARS) from your student record:
A
uthorization permission: Yes No
4. PERSONAL STATEMENTS:
N
EUROSCIENCE RESEARCH EXPERIENCE ESSAY (REQUIRED)
M
ust be between 500 and 750 words. Provide a brief description of what neuroscience experience you would like to
have and how that would further your career. If you have already identified a mentor and research group who has
accepted you into the lab group, describe the nature of your project. If you know what kind of research experience
you desire, but have not yet identified a lab, describe the range of interests that you would consider. In either case,
discuss how this experience will help you achieve your career goals. Include details of your previous or current
research such as: Dates (month/year-month/year) and approx. total hours, mentor (and institution, if not UCLA).
FINANCIAL NEED STATEMENT (OPTIONAL)
This statement is only required if you are applying for the additional $7,500 supplement (simply write “N/A” if it does not
apply to you).
Must be between 100 and 750 words. Please touch on the following topics, and anything else you’d like us to know
about you:
• Your family, education, and community background
• What would prevent you from having this experience without the Scheibel Scholarship
• How you anticipate this award will make a difference in your life
• Please explain the financial need for the scholarship
5. RÉSUMÉ/CV:
Provide a résumé/CV that includes any information on your educational background, awards, scholarships, outside
activities, specialized skills or leadership positions that you would like us to take into consideration. Please upload as
a separate word document or pdf file. (Please title this document “Scheibel CV- [your first and last name]”.)
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