Thank you for being interested in our Fall 2023 Teen Science Ambassador Program.
Before filling out this application, we encourage you to read our eligibility requirements on our website .
Please check Yes to confirm that you read over the eligibility requirements.
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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)
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Is this student's main application? Yes
No
Will be sixteen before June 1st, 2023?
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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). Learn more on our website .
School Email Address
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Phone Number
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Home Address
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Can you attend Tuesday meetings (4-6 pm) starting August 29th - November 14th?
Ambassadors are paid for their time and will have paid internships available to them.
In-person meetings will take place at MUSC Charleston location.
* 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 twelve 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 12 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.
Please share your pronouns.
Examples
she/her/her
she/they
she/he/they
he/him/his
he/they
they/them/theirs
Why this matters- https://www.mypronouns.org/what-and-why/
Ethnicity
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Hispanic or Latino
Not Hispanic or Latino
Racial Identity - Please check all that apply
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Do you attend a school within Charleston County?
Yes
No
We appreciate your interest in the Teen Science Ambassador program. For this program, we are inviting 10th and 11th-grade students who attend schools within Charleston county. Our team offers paid research opportunities and clinical services for teens and young adults.
Learn more on our website.
High School Name
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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?
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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 10th and 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 fall, will you be involved in any clubs, sports, or other extracurricular activities?
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Yes
No
Will you still be available to attend our meetings on Tuesdays from 4-6 pm?
Meetings will take place at 67 President St, Charleston, SC 29425 (meetings will take place in person).
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Yes
No
What days do you attend your extracurricular activities?
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Who do you think is a great example of a leader, and why?
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As an individual from an underrepresented population in Science, Technology, Engineering, and Math (STEM) field, how could this program help you on your journey?
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Do you currently have a job?
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Yes
No
We will meet every Tuesday, starting on August 29th- November 14th, we will meet with our Ambassadors.
Will you be able to join us on Tuesdays for the in-person meetings?
Yes
No
Do you plan on working next semester?
Every Tuesday starting on August 30th- November 8th, we will meet with our Ambassadors.
Our Ambassadors will receive dinner, travel assistance, and compensation for their time in the program.
* must provide value
Yes
No
What days do you typically work?
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Company Name
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Your Position
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Number of Hours Worked Per Week
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Please provide a brief description of job duties.
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Do you have any previous job experience?
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Yes
No
Company Name
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Your Position
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Number of Hours Worked Per Week
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Please provide a brief description of job duties.
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Did you have another job experience?
* must provide value
Yes
No
Company Name
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Your Position
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Number of Hours Worked Per Week
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Please provide a brief description of job duties.
* must provide value
Did you have another job experience?
Yes
No
Company Name
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Your Position
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Number of Hours Worked Per Week
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Please provide a brief description of job duties.
* must provide value
Are you interested in attending college after high school?
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Yes
No
Maybe
Are you interested in pursuing a degree in STEM and or Medicine?
* must provide value
Yes
No
Maybe
What are you thinking about doing after high school?
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What are you thinking about doing after high school?
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What are you thinking about doing after high school?
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A first-generation college student is a student whose parent(s) did not complete a four-year college or university degree. However, we understand that this definition may not fully account for the rich diversity of first-generation college students. For example, your parent(s) could have some college experience but did not earn a degree from a four-year college or university. Your grandparents, aunts/uncles and siblings could also have degrees, and you would still qualify as first generation. (Adapted from Loyola University Chicago)
Will you be a first-generation college student?
Yes
No
Do you have a mentor?
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Yes
No
Does your mentor work in your dream career?
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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, or another non-family member who knows you well.
We encourage you to reach out to your reference and let them know you are applying for this program.
Reference 1 Name
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Reference 1 Phone Number
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Reference 1 Email
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Reference 1 Relationship to You
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Coach
Family Friend
Guidance Counselor
Teacher
Other
If other, please describe relationship:
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Would you like to add an optional reference?
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Yes
No
Optional Reference Phone Number
Optional Reference Relationship to You
Coach
Family Friend
Guidance Counselor
Teacher
Other
If other, please describe relationship:
Should we contact ______ 's reference? Yes
No
Did ______ 's reference complete the form? Yes
No
Guardian Name
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Guardian Phone Number
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Guardian Email
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Relationship to You
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Parent
Grandparent
Adult Family Member ( Sibling, Aunt, Uncle, Cousin, Another Relative)
Other Legal Guardian
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?
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Event/ Flyer
Online
Past Ambassador
Teacher/ Guidance Counselor
Metanoia
Other
What is your t-shirt size?
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Small
Medium
Large
X-Large
XX- Large
XXX- Large
Do you have any food allergies or special dietary needs?
* must provide value
Yes
No
Yes
No
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
Potential for Leadership
Access to STEM Opportunities
Application Screening Score
View equation
Do we recommend ______ for a pre-interview?
Yes- 4 out of 4
Yes- 3 out of 4
Maybe- 2 out of 4
No- 1 out of 4
Pre-Interview - Day and Time
Now M-D-Y H:M
Interest in STEM
(composite score of both reviewers)
Interest in STEM/ MUSC or Willingness to learn about substance research
Potential for Leadership
(composite score of both reviewers)
Potential for Leadership
Enthusiasm for the Program
Combined Pre-Interview Score
View equation
Please type the student's combined Pre-Interview Score:
Do we recommend ______ for a second interview?
Yes- 24-30
Maybe- 13-23
No- 6-12
Now M-D-Y H:M
Interest in STEM/ MUSC or Willingness to learn about substance research
Interest in STEM/ MUSC or Willingness to learn about substance research
Enthusiasm for the Program
Potential for Leadership
View equation
Please type the student's combined interview score:
Did ______ 's reference, ______ ______ complete the reference check survey? Reference Final Recommendation- ______ ______
Yes
No
Do you recommend ______ for the final TSAP selection conversation?
Yes
No
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