2025 Dubois Nubian Junior Research Fellowship Program

Student First Name (as it appears on your Social Security card)

Name of School

Date of Birth

Student ID #

Student Last Name (as it appears on your Social Security card)

Email (that is regularly checked)

Phone

Address

If you are in Grade 12, you must give us an email address that you regularly use, not your school address.

Parent / Legal Guardian (OPTIONAL)

First Name

Address

Last Name

Phone

Why are you interested in this position?

List Extra-curricular activities:

List the 3 most important academic classes you took in your recent academc year:

NB: BOSTON RESIDENTS MUST UPLOAD PROOF OF RESIDENCE AND PROOF OF AGE.

Boston residents cannot be offered a job unless the documents requested below are provided.

Proof of Residence

Upload png or jpg

Upload supported file (Max 15MB)

Proof of Age

Upload png or jpg

Upload supported file (Max 15MB)

Resume & Cover letter

Upload supported file (Max 15MB)

Your Signature

I agree to a CORI / SORI check