Pediatric Research and Clinical Education Program (PReCEP) Application

Start: Tuesday, May 30, 2023

End: Friday, July 21, 2023

Completed applications will be sent to Alyssa McCarron.

Applications are due Wednesday, March 1, 2023.

* = Required Fields

Name*
Address*
Email*
Phone*	() -
Check your top 3 areas of interest* Allergy, Asthma, & Immunology Ambulatory Pediatrics Cardiology Child Development Critical Care Emergency Medicine Endocrinology Forensic Medicine Gastroenterology General Pediatrics Hematology/Oncology Hospital Pediatrics Infectious Diseases Neonatal Medicine Nephrology Neurology Palliative Medicine/Complex Care Pulmonary Rheumatology
List the name(s) of any potential mentor(s) you have already been in contact with
Identify any research topics/areas of interest (optional)
Will you be available to work during the entire summer program?*	Please select... Yes No
If No, please identify any periods of 2 or more consecutive working/business days during which you will be unavailable
Will you be available to present your work on the last day of the program?*	Please select... Yes No
The pediatric research positions are intended to provide M1 students clinical and research experience in pediatrics. Please provide a brief description of your interests in a pediatric career and your goals for this summer experience.*