Student Research Interest Form * Required Information

Thank you for your interest in undergraduate research and creative projects! Please complete this form to tell us about yourself and your research interests and goals. You will also have the opportunity to request an appointment with one of our Research Counselors.

As you are completing the fields below, please capitalize only the first letter of names, proper nouns, and sentences. Do not type in all capitals.

First Name*    Middle Initial   Last Name*

Student ID*
       If you do not have a UCI Student ID, input 0 (zero)


Additional Majors, If Applicable

Expected Graduation Date*

Education Goals BS/BA   MS/MA   Ph.D.   MD   JD   Other
           If Other, please indicate:

Career Goals

Research Goals

What types of opportunities are you interested in?* (Check all that apply)

On-campus  Off-campus (academic year)  Off-campus (summer)

Select up to three areas of research that you are most interested in pursuing*

Please elaborate on your research interests and any prior research experience, as applicable

Contact Information
Please provide us with your current contact information.

Street Address*

City*   State*    Zip*

Phone Number*
Format: (999) 999-9999

UCI E-mail Address *
       If you do not have a UCI E-mail Address, please input "none."

If you prefer we contact you at a different E-mail address, please provide an alternate:

Survey Information

How did you hear about UROP?  
       If "Other", please indicate: 

Double-check that your information is correct,
then click the Continue button.