Course Application Deadline: Day before course starts Financial Assistance Application "Priority Date:" March 15 In addition to this application form, two pieces of supplementary material may be required. 1. Transcripts: Copies of all your college transcripts are required. Unofficial transcripts are fine. UVA students - By submitting this application you are giving us permission to access your UVA transcripts directly. You need not send them to us. 2. Letter of recommendation ONLY if you are requesting financial assistance: Submit one letter of recommendation from a faculty member or similar academic instructor or advisor who knows you and your potential. Referee should send letter directly to MLBS. SUMMER 2024 PROGRAM Personal Information Name First * Middle Last * Current Contact Information Address Line 1 Address Line 2 City State/Province Zip/Postal Code Cellphone number & Provider * This information can help us locate you in case of emergency. Email * Permanent or Home Contact Information Address Line 1 * Address Line 2 City * State/Province * Zip/Postal Code * Other Email Emergency Contact Name * Phone * Dietary, Health, Safety, and Personal Needs: MLBS is a remote field station with limited facilities, access, and communications. Many activities occur outdoors in unpredictable and demanding weather and physical conditions. Emergency medical response time is 30 minutes or more. Please indicate any medical, dietary, or personal needs that may require special consideration or accommodation (e.g. disability, medication storage, allergies, personal comfort needs). With advance notice, the dining hall can accommodate food allergies and dietary restrictions including vegetarian, pescatarian, vegan, no red meat, no pork, celiac disease. 40 word limit; please list concerns concisely. You may also contact us at 540-626-7196 or mlbs@virginia.edu to discuss anything else you want to share regarding your safety, wellbeing, and comfort at the Station. Housing requests or concerns Sex / Gender Identity (for housing assignment) * Female Male Other / Preferred Pronouns? Sex / Gender Identity (for housing assignment) Other / Preferred Pronouns? Age when you arrive at MLBS * 17 or younger 18 - 20 years old 21 or older Student Status * Undergraduate Graduate Other... Student Status Other... Current College or University * Expected Graduation * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20242025202620272028202920302031203220332034 Major * Overall GPA * Major GPA * Please list all colleges or universities attended. Include dates and any degrees Do you qualify for University of Virginia "in-state resident" fees? * Yes No What is your state or country of residence? How did you learn about Mountain Lake? Check all that apply Brochure, Poster or Display made available through my school Email Campaign Web site Current or former Mountain Lake student Current or former Mountain Lake faculty Instructor or Advisor On-line database or student opportunities clearing house Other... How did you learn about Mountain Lake? Check all that apply Other... If you have been to Mountain Lake Biological Station before, when? And in what capacity? Course Selection Session I - NOTE: You may only register for one course per session. PLANT CONSERVATION AND DIVERSITY FIELD HERPETOLOGY Session II FIELD BIOLOGY OF FISHES Session III WILDLIFE DISEASE ECOLOGY Financial Assistance Request (optional) Complete this section only if you wish to be considered for MLBS financial assistance (this is not at all related to any other financial aid award you may have). Funds are granted to help defer tuition, housing, and/or dining costs while taking a class at MLBS. Awards are made while funds are available and are based on academic record and financial need. A statement of need and letter of recommendation are required. Financial support recipients will be called upon to assist with tasks and special work projects each week at the Station. Weekend projects may be required. Work load varies over the summer, but efforts are made to accommodate class schedules. Review of applications for financial support begins March 15. Later applications may be considered if funds are available. aid_request Check to request financial assistance Statement of Financial Need: Please provide a brief statement of financial need as it relates to your ability to enroll in a course at MLBS. Supplementary Material 1. Transcripts: Copies of all your college transcripts are required. Unofficial transcripts are fine. UVA students - By submitting this application you are giving us permission to access your UVA transcripts directly. You need not send them to us. 2. Letter of recommendation, ONLY if you are requesting financial assistance: Submit one letter of recommendation from a faculty member or similar academic instructor or advisor who knows you and your potential. Referee should send letter directly to MLBS. Send all supplementary material to: Mountain Lake Biological Station University of Virginia P.O. Box 400327 Charlottesville, VA 22904-4327 eml: mlbs@virginia.edu (do not use for sensitive personal material) fax: 434-982-5626 (ATTN: MLBS) Thank you very much! For questions about the program or your application please call 434-982-5486 or email mlbs@virginia.edu. Mountain Lake Biological Station values diversity and is committed to equal opportunity and affirmative action in all its programs. When you are ready . . . CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.