The code block below illustrates how one might use # and // as comments in your logic and calculations.

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Required format:

bVZA3gBmdo6qaXo7LgKwk8phH8oI2AXbMEwqknARps8CxhvnSgLcKhG8qf2Ev2ccwHE66ahYpknFYpI5mQeBFIKuygayCmyaPbMvQN9Xt6J8hpL

Student Research Interest Form

Thank you for your interest in a research student experience at Beth Israel Lahey Health (BILH). To help facilitate your request, we have created a form for you to share information about your background, interest areas, work availability.

Please note that filling out this form is not a guarantee of being connected to a Department and/or receiving an offer to conduct research at BILH.

Any questions about this form and process should be directed to the Office of Student Engagement and Experience at osee@bilh.org. You can also schedule a meeting with Ethan Selinger, Program Director of the Office of Student Engagement and Experience, to discuss your interests and/or questions about this process here: https://calendly.com/eselinge-bidmc/30min

Additionally, opportunities may exist on the "opportunities for research students (constantly updated)" and BILH Careers Page. Please don't hesitate to review these pages.

First and Last Name

* must provide value

School or Institution

* must provide value

Anticipated graduation date (month/year)

* must provide value

What is your email address?

* must provide value

What is your phone number?

* must provide value

Level of Experience

* must provide value

Current Major (if high school, please select N/A)

* must provide value

Will you receive academic credit for a research opportunity at BIDMC, and/or will this satisfy a graduation requirement?

* must provide value

Yes

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If you selected yes to the question above, please explain further. If not, please explain how a research opportunity will benefit your academic learning and career goals?

* must provide value

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What type of research interests you? Please select all that apply

* must provide value

Basic Science Research

Clinical Research

Translational Research

What type of research environment interests you? Please select all that apply

* must provide value

Wet Lab

Dry Lab/Computational

Other

Please briefly describe your research and career interests (3-5 sentences) and upload it here

* must provide value

Upload file

Please upload a copy of your resume or CV

* must provide value

Upload file

What time period(s) are you eligible/able to participate in research at BIDMC?

* must provide value

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Have you been referred to fill out this form by a contact at BIDMC?

* must provide value

Yes

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What is your preferred work modality?

* must provide value

In-Person

Hybrid

Remote

Are you authorized to work in the United States?

* must provide value

Yes

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Is there anything else you would like us to know?

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In addition to filling out this form, if you would like to meet with the BIDMC Office of Student Engagement and Experience (OSEE) to discuss your research interests further, please don't hesitate to schedule a time to connect: https://calendly.com/eselinge-bidmc/30min

Student materials sent to PI?

Most recent date materials were sent

M-D-Y H:M

Department Interested?

Matched?

Yes

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Hire made by PI and reported to OSEE?

Yes

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Offer Letter Sent?

Yes

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Intake Form submitted to PI to complete?

Yes

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Intake Form Completed?

Yes

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Materials Submitted to Research Onboarding Inbox?

Yes

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Notes

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BIDMC Relationship

* must provide value

Yes

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Volunteer/WFD Student

* must provide value

Yes

reset

Student from OSEE partner

* must provide value

Yes

reset

Direct PI Hire

* must provide value

Yes

reset

Met with OSEE?

Yes

reset

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.