Thank you for your interest in our Fall 2023 Teen Science Ambassador Program.
Before filling out this application, we encourage you to read over our eligibility requirements on our website .
Please check Yes to confirm that you read over the eligibility requirements.
* must provide value
Yes
No
Please read over the eligibility requirements found here website . Once you finish reading over the requirements, please go back and change your answer to the first question.
Name (first and last name) * must provide value
Preferred first name
Is this student's main application? Yes
No
Will be sixteen before June 1st, 2023? * must provide value
Yes
No
We appreciate your interest in the Teen Science Ambassador program. Our team looks forward to seeing you apply next year. All of our Ambassadors must be at least 16 years old. However, we offer paid research opportunities and clinical services for teens and young adults (12-25).website .
School Email Address* must provide value
Phone Number* must provide value
Home Address* must provide value
Can you attend Tuesday meetings (4-6 pm) starting August 29th - November 14th? * must provide value
Yes
No
We appreciate your interest in the Teen Science Ambassador program. This program meets on Tuesdays at this time. If you need help with transportation, our team can help make arrangements for you to attend.
In addition to offering this program, we offer paid research opportunities and clinical services for teens and young adults.
Learn more on our website.
We will have eleven weekly meetings. Can you attend at least nine meetings? * must provide value
Yes
No
We appreciate your interest in the Teen Science Ambassador program. This program requires all paid Ambassadors to attend at least 9 out of the 11 meetings.
In addition to offering this program, we offer paid research opportunities and clinical services for teens and young adults.
Learn more on our website.
Pronouns she/her/hers
he/him/his
they/them/theirs
Another pronoun that is not listed above
Pronouns
Ethnicity * must provide value
Hispanic or Latino
Not Hispanic or Latino
Racial Identity - Please check all that apply * must provide value
White
Hispanic or Latino
Black or African American
Native American
Asian / Pacific Islander
Another racial identity that is not listed above
High School Name* must provide value
Academic Magnet High School Allegro Charter School for Music Baptist Hill Middle High School Burke High School Charleston Charter for Math and Science Cooper River Center for Advanced Studies Early College High School East Cooper Center for Advanced Studies Greg Mathis Charter High School James Island Charter High School Lucy G. Beckham High School Military Magnet Academy North Charleston High School R.B. Stall High School St. John's High School Wando High School West Ashley Center for Advanced Studies West Ashley High School Another School in Charleston County
What is the name of your school? * must provide value
In August, will you be in the 11th grade? * must provide value
Yes
No
We appreciate your interest in the Teen Science Ambassador program. For this program, we are inviting rising 11th-grade students to apply. Our team offers paid research opportunities and clinical services for teens and young adults.
Learn more on our website.
Next year, I will be in the __________. * must provide value
10th grade
11th grade
Next fall, will you be involved in any clubs, sports, or other extracurricular activities? * must provide value
Yes
No
What days do you attend your extracurricular activities?* must provide value
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday/Sunday
Will you still be available to attend our meetings on Tuesdays from 4-6 pm? * must provide value
Yes
No
Please explain why you are interested in this position. * must provide value
As an individual from an under-represented population in STEM, how would participating in this program ... * must provide value
Who is a leader you admire, and what qualities about them led you to admire them? * must provide value
Is there anything about yourself that you would like to share with our team?
Do you plan on working next semester? * must provide value
Yes
No
Do you currently have a job?* must provide value
Yes
No
Company Name* must provide value
Your Position* must provide value
Number of Hours Worked Per Week* must provide value
Please provide a brief description of job duties.* must provide value
Do you have any previous job experience?* must provide value
Yes
No
Company Name* must provide value
Your Position* must provide value
Number of Hours Worked Per Week* must provide value
Please provide a brief description of job duties.* must provide value
Did you have another job experience?* must provide value
Yes
No
Company Name* must provide value
Your Position* must provide value
Number of Hours Worked Per Week* must provide value
Please provide a brief description of job duties.* must provide value
Did you have another job experience? Yes
No
Company Name* must provide value
Your Position* must provide value
Number of Hours Worked Per Week* must provide value
Please provide a brief description of job duties.* must provide value
Are you interested in attending college after high school? * must provide value
Yes
No
Maybe
Are you interested in pursuing a degree in S.T.E.M. and or Medicine? * must provide value
Yes
No
Maybe
In 2-3 sentences, please share what you currently plan to do after high-school* must provide value
A first-generation college student is a student whose parent(s) did not complete a four-year college or university degree.
Would you be classified as a first-generation college student?
Yes
No
Do you have a mentor? * must provide value
Yes
No
Does your mentor work in your dream career? * must provide value
Yes
No
Next spring and summer, our Ambassadors will be invited to a paid internship within our department. Will you be available this summer and or fall to participate in the internship? * must provide value
Yes
No
Maybe
Our team is excited to learn more about you. We ask all of our potential Ambassadors for at least one reference. This person can be a teacher, coach, non-family member who knows you well. Reference 1 Name* must provide value
Reference 1 Phone Number* must provide value
Reference 1 Email* must provide value
Reference 1 Relationship to You* must provide value
Coach
Family Friend
Guidance Counselor
Teacher
Other
If other, please describe relationship:* must provide value
Would you like to add an optional reference? * must provide value
Yes
No
Optional Reference Name
Optional Reference Phone Number
Optional Reference Email
Optional Reference Relationship to You Coach
Family Friend
Guidance Counselor
Teacher
Other
If other, please describe relationship:
Guardian Name * must provide value
Guardian Phone Number* must provide value
Guardian Email* must provide value
Relationship to You* must provide value
Parent
Grandparent
Adult Family Member (Aunt, Uncle, Cousin)
Legal Guardian (Foster Parent)
Caseworker
Have you ever worked or participated in a program at MUSC? Yes
No
Did you attend a Teen Science Ambassador program infomational session? * must provide value
Yes
No
How did you hear about the Teen Science Ambassador program? * must provide value
Event/ Flyer
Online
Past Ambassador
Teacher/ Guidance Counselor
Metanoia
Other
Please share more.
Recruitment Notes Is ______ eligible? Yes
No
Application Complete Yes
No
Is the applicant is in the recruitment matrix excel worksheet on box? Yes
No
Application Screening Notes Did we complete an application screening? Yes
No
Curious in STEM
Potential for Leadership
Ability to Grow
Access to STEM Opportunities
Motivation
Application Screening Score View equation
Do we recommend ______
Yes- 4 out of 4
Yes- 3 out of 4
Maybe- 2 out of 4
No- 1 out of 4
Pre-Interview Notes Pre-Interview - Day and Time Now M-D-Y H:M
Interest in STEM
Interest in STEM/ MUSC or Willingness to learn about substance research
Potential for Leadership
Potential for Leadership
Enthusiasm for the Program
Combined Pre-Interview Score View equation
Interview Notes Do we recommend ______ for a second interview? Yes- 24-30
Maybe- 13-23
No- 6-12
Interview- Day and Time Now M-D-Y H:M
Interest in STEM
Interest in STEM/ MUSC or Willingness to learn about substance research
Potential for Leadership
Interest in STEM/ MUSC or Willingness to learn about substance research
Enthusiasm for the Program
Potential for Leadership
Combined Pre-Interview Score View equation
Selection Notes Did ______ 's reference, ______ ______ ______ ______
Yes
No
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