MCG AME Application

Thank you for your interest in the Applied Molecular Epidemiology Summer Internship.
Applicants must be at least 16 years old by June 2, 2025 to enroll. Prior work experience is not required.

Please complete this application form and contact AME_Internship@augusta.edu if you have questions. After submission, you will be able return to your application to upload the remaining required documents, including a health questionnaire completed by your physician and unofficial transcripts.

Personal Information

First Name

Preferred First Name

Middle Name

Last Name

Email Address

Phone Number

Birthdate

Will you be under the age of 18 at the start of the AME Experience?

Gender

What is your race? Please select all that apply.

Please attach a photo ID. Please see photo requirements here.

School Contact Information

Address:

Country

Street

City

Region

Postal Code

Teacher/Advisor Name (how you heard about the internship)

Phone Number

Email Address

Parent/Guardian Information

Parent/Guardian Name

Parent/Guardian address

Country

Street

City

Region

Postal Code

Parent/Guardian Cell Phone Number

Add another parent

Parent/Guardian Information

Parent/Guardian Name

Parent/Guardian address

Country

Street

City

Region

Postal Code

Parent/Guardian Cell Phone Number

Citizenship Information

Citizenship Status

Country of Citizenship

Visa Status (if applicable)

Education

Please list the high schools and colleges you've attended starting with your current institution.

Current School Name

Started Attending

Expected Graduation Year

Current grade

Add another school

Additional School Name

Started Attending

Ended Attending

Add another school

Additional School Name

Started Attending

Ended Attending

Academic Goals & Honors

What future academic education are you planning to pursue after high school graduation? (check all that apply)

If other, please specify:

Interest Survey

The Applied Molecular Epidemiology Summer Internship provides a snaphshot of a new field that combines laboratory science (testing), epidemiology (tracking the spread of infectious disease) and bioinformatics (providing data visualizations to inform decision-making for the public's health).

In 2-3 sentences, explain what you hope to gain from the 6-week internship.

Share what you think is most exciting about molecular epidemiology.

Briefly, explain how the AME experience can support your future career goals.

Health Insurance Coverage

Yes, I currently have health insurance coverage that will be in effect for the duration of the internship. I understand I must provide proof of this health insurance coverage to participate in the internship.

No, I do not have health insurance coverage.

Submission

All personal data and special categories of sensitive personal data collected or processed by the USG must comply with the USG Cybersecurity Plan, as authorized by the Board of Regent Policy Manual Section 10.4 Cybersecurity. Anyone suspecting his or her sensitive personal data has been exposed to unauthorized access, report your suspicion to helpdesk@usg.edu. Otherwise, questions concerning GDPR can be forwarded to gdpr@usg.edu.

In signing this application, I hereby certify that all statements herein are true, correct and complete and that I have not omitted any information requested. I understand that submission of erroneous information, whether intentional or unintentional, may nullify my admission.

I authorize Augusta University and my home institution to disclose and exchange my educational records for the purpose of determining my eligibility to participate in the program and to evaluate my participation, if I am accepted.

After reading and confirming, type your name in the certification field below as you would sign official documents.