Application Form

DEADLINE: 11:59 PM MDT, JUNE 15

This form allows you to enter all the necessary information to apply for the Mentored Experiences in Research, Inquiry and creaTivity for Undergraduate Scholars (MERITUS) for the upcoming academic year.
You must complete the form in its entirety in order to submit.

Links are provided to upload your personal statement and transcript, as well as the project description and mentoring plan. Please refer to the Proposal Guidelines to prepare these documents.

Form Login Account (optional but highly recommended)

You will be allowed to submit only once. Creating an account will enable you to to partially complete this form, save it, and return later to finish the form. The login account you create is only for this form.

New Users / Returning Users CLICK HERE to setup or return to your account for this form.

Upload the required documents as indicated

Upload the MENTOR PROFILE FORM in PDF format. Be sure to follow guidelines as stated in the opportunity announcement. *

Upload SUPPORTING IMAGES (OPTIONAL) in PDF format here. Be sure to follow guidelines as stated in the opportunity announcement.

Upload the MENTEE SELF-EVALUATION in PDF format. Be sure to follow guidelines as stated in the opportunity announcement. *

Upload the MENTORING AGREEMENT in PDF format. Be sure to follow guidelines as stated in the opportunity announcement. *

Upload the UNOFFICIAL TRANSCRIPT (Goldmine Printout) in PDF format here. *

Proposed Research Project Information

Which project theme does yours belong to *

Research Project Title *

Research Project Abstract (500 words) *

0/510 words

IRB. Does your project involve animal subjects or human subjects (surveys/focus groups/interviews)? *

Yes

No

If yes, your project likely requires Institutional Review Board (IRB) or Institutional Animal Care and Use Committee (IACUC) approval. Discuss this with your mentor and answer questions IRB1, and IRB2 or IRB3 as applicable.

IRB1. Has the project received IRB or IACUC approval?

Yes

No

IRB2. If yes, upload a PDF copy of the IRB or IACUC approval letter here

IRB3. If no, enter the date you anticipate receiving IRB or IACUC approval. Note: Students will not receive hourly compensation for projects involving animal or human subjects until IRB approval is received.

Student Personal Information

Student - First Name *

Student - Middle Name/Initial

Student - Last Name *

Miner ID Number *

Date of Birth (mm/dd/yyyy) *

Student - Gender *

Student - Cell Phone *

Student - Home/Other Phone

Student - Email Address *

Re-enter Email Address *

I am a *

U.S. citizen	U.S. legal resident (green card holder)
International student (F, J visa)	Other - with proper documentation for employment

Answering the questions below about race, ethnicity and national origin (if international) is optional. Information collected, however, will be used for important statistics relevant to grant applications in which individual identities will not be revealed. Your cooperation is highly appreciated

Ethnicity

Hispanic or Latino

Not Hispanic or Latino

Race (select all that apply)

National Origin

U.S. Citizen

Mexican National

Other Other

Primary Mentor Information
NOTE: Must have a full-time faculty appointment

Primary Mentor - First Name *

Primary Mentor - Middle

Primary Mentor - Last Name *

Primary Mentor Title/Position *

Primary Mentor is a faculty member in the Department of *

If not an academic department, please specify

Primary Mentor Email Address *

Re-enter Primary Mentor's Email Address *

Primary Mentor's UTEP Expertise profile URL 🛈

Do you have a second mentor/advisor? *

Yes

No

Secondary Mentor/Advisor Information

Secondary Advisor - First Name *

Secondary Advisor - Last Name *

Secondary Advisor is a faculty member in the Department of *

Secondary Advisor; If not an academic department, please specify

Secondary Advisor Email Address *

Re-enter Secondary Advisor's Email Address *

Student Academic Information

Major *

Second Major (if double major)

Are you a transfer student? *

Yes

No

Name of previous institution *

Current overall GPA *

Expected date of graduation (MM/YY) *

Which of the following best describes your plans after graduation with a bachelor's degree? (Select one) *

Graduate School or PhD Bound

Professional School Bound (Dental, Medical, Pharmacy, etc.)

Teaching Bound (Elementary, Middle, High School)

Workforce bound (other than teaching)

Have you previously participated in URSCA? *

Yes

No

For how many semesters? (8 week summer = 1 semester) *

Student Personal Statement (600 Words) *

0/625 words

Student Finances

Do you currently have or participate in any of the following? *

Scholarship/Fellowship

UTEP Student Employment/Workstudy

Research Stipend/Program

No other funding

You indicated another source of funding above, please provide the source of funds (name and contact info of fellowship program, name/email of supervisor, research grant faculty PI, etc). *

Do you have an off-campus job? *

Yes

No

For how many hours of work per week?

Please enter the name of your employer (company/office name). *

0/50 words

Have you applied for or currently receive financial support to conduct research? (e.g. stipend, RISE program, etc.) * 🛈

Yes

No

Please list the name(s) of the program 🛈

+-

Please indicate if you have any additional commitments that may prevent you from working 15 hours a week on this project. 🛈

+-

Important Note:

If you were to be accepted into the COURI MERITUS Program, you are expected to

commit to at least 15 hrs/week for 16 weeks during each fall/spring semester,
research related activities including attendance of professional development workshops,
be enrolled at least 12 semester credit hours (SCH) each term and
in your mentor's Zero-Credit Undergraduate Research Course (RSRC 4033).

IMPORTANT NOTE

You are almost done.

The system will allow you to submit only once.

PLEASE, CAREFULLY REVIEW YOUR ANSWERS BEFORE SUBMITTING

It is highly recommended that you create a login/password if you will take more than one session to complete this application.
If you have questions, contact us at meritus@utep.edu.

How did you hear about MERITUS?

My email below indicates that all information provided herein is true and correct to the best of my knowledge. *

Retype e-mail address *

Informed Consent: Click here if you would allow COURI permission to utilize your personal statements for future research projects. Note: This does not impact your eligibility/selection for the program. *

I consent

I do not consent

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