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Summer Undergraduate Research Fellowship (SURF) Program Application Form

* Required fields

** NOTE: If there is an apostrophe in your name, your school name or your address, please omit when entering the information into the application.

Biographical Info

Current Contact Information/Mailing Address (School Address)
Permanent Address
Academic Info
Additional Academic Information (if appropriate)
If you have attended more than one undergraduate institution, please submit official transcripts from all institutions attended.
SURF Physician-Scientist Program (SURF PS) Option
The SUNY Upstate Medical University SURF Physician-Scientist Program is a special pathway and admissions option of the Summer Undergraduate Research Fellowship (SURF) Program. This initiative is aimed at exposing a small number of undergraduates (3-4) to the career path of a physician-scientist. It is specifically designed for those students interested in pursuing an MD/PhD, and that have backgrounds under-represented in science and healthcare. Consideration does not exclude you from the traditional SURF program.

Two recommendation letters are required. Letters of recommendation may be requested from professors related to your major, an advisor, and/or department chair. Recommendation letters can be mailed, or emailed, by your recommender to the program. See mailing infromation below.

Reference 1
Reference 2
Reference 3 (Optional)
Personal Statement
Describe your reasons for wanting to attend the SURF or SURF PS program. Please include your academic goals, some areas of research in the Biomedical Sciences which currently interest you, and your future career plans. You may
  • Upload a Word or PDF document
  • or paste your information into the box from a document
  • or enter your information directly into the box
Additional Info

Other Information

Deadline date for application: February 16, 2018

Please have official transcript(s) and recommendation letters sent to:

SUNY Upstate Medical University
College of Graduate Studies
SURF Program
Room 3122, Weiskotten Hall
766 Irving Ave
Syracuse, NY 13210
Phone: 315 464-4538
Fax: 315 464-4544
Program Website:

The Personal Privacy Protection Law requires this notice to be provided when collecting personal information from individuals. The information on this application will be used by SUNY Upstate Medical University, College of Graduate Studies, to evaluate your request for acceptance to the Summer Research Program. The authority to request this information is found in Section 355 (2) (i) of the Education Law.

SUNY Upstate Medical University in Syracuse NY is an Equal Opportunity/Affirmative Action Employer and compliant with the Title IX of the Education Amendments of 1972.