Intern Application
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Name: *
Address: *
City, State, Zip: *
Home Phone: *		Cell Phone:
UCSD Student ID#: *
E-mail Address: *
Quarter: *	Fall Winter Spring Summer
Eligibility Requirements: Junior/Senior Standing (Successfully completed 90 units) Minimum 3.0 GPA Required Prerequisites: BIMM 100 Molecular Biology BICD 100 Genetics BIBC 102 Metabolic Biochemistry BIBC 103 Biochemical Techniques (Must be complete before applying) Internship for 14 hours per week for 10 weeks. In the industry laboratories One meeting scheduled each month with Course A monthly meeting with course instructor is required. A final formal presentation reflecting coursework is presented at the end of the quarter

Check the Upper-Division classes you have completed. Fill out all fields
Completed	Currently Enrolled	Not Taken	* Required Courses + Recommended Courses
			BIBC 102 *	Metabolic Biochemistry *
			BIBC 103 *	Biochemical Techniques *
			BICD 100 *	Genetics *
			BIMM 100 *	Molecular Biology *
			Chem 140A +	Organic Chem *
			Chem 140B +	Organic Chem *
			Chem 143A +	Organic Chem Lab *
			BIBC 100 +	Structural Biochemistry *
			BICD 110 +	Cell Biology *
			BIMM 101 +	Recombinant DNA *

Electives/Lab Coursework (please list)	CSE Coursework (please list)
List special interests in the Biology field: *
List special work experience and/or skills: *
After interning in the winter/spring quarters for credit, are you available to work at the same company during the summer? * Yes No
All fields marked with a * are required.