Alabama (AL) Alaska (AK) American Samoa (AS) Arizona (AZ) Arkansas (AR) California (CA) Colorado (CO) Connecticut (CT) Delaware (DE) District of Columbia (DC) Florida (FL) Georgia (GA) Guam (GU) Hawaii (HI) Idaho (ID) Illinois (IL) Indiana (IN) Iowa (IA) Kansas (KS) Kentucky (KY) Louisiana (LA) Maine (ME) Maryland (MD) Massachusetts (MA) Michigan (MI) Minnesota (MN) Mississippi (MS) Missouri (MO) Montana (MT) Nebraska (NE) Nevada (NV) New Hampshire (NH) New Jersey (NJ) New Mexico (NM) New York (NY) North Carolina (NC) North Dakota (ND) Northern Mariana Islands (MP) Ohio (OH) Oklahoma (OK) Oregon (OR) Pennsylvania (PA) Puerto Rico (PR) Rhode Island (RI) South Carolina (SC) South Dakota (SD) Tennessee (TN) Texas (TX) Trust Territories (TT) Utah (UT) Vermont (VT) Virgin Islands (VI) Virginia (VA) Washington (WA) West Virginia (WV) Wisconsin (WI) Wyoming (WY)
She/Her/Hers
He/Him/His
They/Them/Theirs
Other
Man
Woman
Non-binary
Prefer not to answer
Do you have a Social Security Number or DACA Student Authorization Number?
*
Yes
No
Do you have an immediate family member employed with CHLA or USC?
*
Yes
No
What is your race and/or ethnicity?Select all that apply and provide additional details in the spaces below.
*
Race/Ethnicity (American Indian or Alaska Native) - Describe
*
Race/Ethnicity (Asian) - Describe
*
Black or African American subgroups
*
Race/Ethnicity (Black or African American) - Describe
Hispanic or Latino subgroups
*
Race/Ethnicity (Hispanic or Latino) - Describe
Middle Eastern or North African subgroups
*
Race/Ethnicity (Middle Eastern or North African) - Describe
Native Hawaiian or Pacific Islander subgroups
*
Race (Native Hawaiian or Pacific Islander) - Describe
Do you have a disability?
*
Yes
No
Prefer Not to Say
Have you been subject to disciplinary action at school or convicted of a crime?
*
Yes
No
IF YES: Please give the approximate date(s) of each incident, explain the circumstances, and reflect on what you learned from the experience.
Please explain the circumstances, and reflect on what you learned from the experience.
*
Today M-D-Y
Today M-D-Y
How did you learn about LA-HIP?
*
Please provide the contact information of the parent or legal guardian we should notify in case of emergency. Contact #1 *
Relationship: First Name: Last Name: Street: City: Zip: Primary Phone: Email: Contact #2 (if appropriate) Relationship: First Name: Last Name: Street: City: Zip: Primary Phone: Email:
Contact #1: Relationship
*
Mother Father Aunt Uncle Other guardian
Contact #1: Phone Number
*
Mother Father Aunt Uncle Other guardian
Is your high school public or private?
*
Public Private
When is your last date of Junior Year?
*
Today M-D-Y
When is your first date of Senior Year?
*
Today M-D-Y
Does your school offer any AP/IB science and math classes?
*
Yes, both subjects No science No math Neither
Are there any restrictions on taking these courses?
Yes No
12 11 10 9
Only juniors are eligible for the 2024-2025 program
Cumulative GPA (un-weighted)
*
List all your high school science and math classes. Please specify whether each course is Regular, Honors, AP or IB (SH or HL) level.
9th Grade Course Title Type
10th Grade Course Title Type
11th Grade Course Title Type
9th Grade: Course 1 (Name)
*
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
9th Grade: Course 1 (Title)
*
9th Grade: Course (Type)
*
Regular Honors AP IB
9th Grade: Course 1 (AP exam)
*
9th Grade: Course 1 (AP exam score)
*
9th Grade: Course (AP exam - scheduled date)
M-D-Y
9th Grade: Course 2 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
9th Grade: Course 2 (Title)
9th Grade: Course 2 (Type)
Regular Honors AP IB
9th Grade: Course 2 (AP exam)
9th Grade: Course 2 (AP exam score)
9th Grade: Course 2 (AP exam - scheduled date)
M-D-Y
9th Grade: Course 3 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
9th Grade: Course 3 (Title)
9th Grade: Course 3 (Type)
Regular Honors AP IB
9th Grade: Course 3 (AP exam)
9th Grade: Course 3 (AP exam score)
9th Grade: Course 3 (AP exam - scheduled date)
M-D-Y
9th Grade: Course 4 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
9th Grade: Course 4 (Title)
9th Grade: Course 4 (Type)
Regular Honors AP IB
9th Grade: Course 4 (AP exam)
9th Grade: Course 4 (AP exam score)
9th Grade: Course 4 (AP exam - scheduled date)
M-D-Y
9th Grade: Course 5 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
9th Grade: Course 5 (Title)
9th Grade: Course 5 (Type)
Regular Honors AP IB
9th Grade: Course 5 (AP exam)
9th Grade: Course 5 (AP exam score)
9th Grade: Course 5 (AP exam - scheduled date)
M-D-Y
10th Grade: Course 1 (Name)
*
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
10th Grade: Course 1 (Title)
*
10th Grade: Course (Type)
*
Regular Honors AP IB
10th Grade: Course 1 (AP exam)
10th Grade: Course 1 (AP exam score)
10th Grade: Course (AP exam - scheduled date)
M-D-Y
10th Grade: Course 2 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
10th Grade: Course 2 (Title)
10th Grade: Course 2 (Type)
Regular Honors AP IB
10th Grade: Course 2 (AP exam)
10th Grade: Course 2 (AP exam score)
10th Grade: Course 2 (AP exam - scheduled date)
M-D-Y
10th Grade: Course 3 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
10th Grade: Course 3 (Title)
10th Grade: Course 3 (Type)
Regular Honors AP IB
10th Grade: Course 3 (AP exam)
10th Grade: Course 3 (AP exam score)
10th Grade: Course 3 (AP exam - scheduled date)
M-D-Y
10th Grade: Course 4 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
10th Grade: Course 4 (Title)
10th Grade: Course 4 (Type)
Regular Honors AP IB
10th Grade: Course 4 (AP exam)
10th Grade: Course 4 (AP exam score)
10th Grade: Course 4 (AP exam - scheduled date)
M-D-Y
10th Grade: Course 5 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
10th Grade: Course 5 (Title)
10th Grade: Course 5 (Type)
Regular Honors AP IB
10th Grade: Course 5 (AP exam)
10th Grade: Course 5 (AP exam score)
10th Grade: Course 5 (AP exam - scheduled date)
M-D-Y
11th Grade: Course 1 (Name)
*
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
11th Grade: Course 1 (Title)
*
11th Grade: Course (Type)
*
Regular Honors AP IB
11th Grade: Course 1 (AP exam)
11th Grade: Course 1 (AP exam score)
11th Grade: Course (AP exam - scheduled date)
M-D-Y
11th Grade: Course 2 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
11th Grade: Course 2 (Title)
11th Grade: Course 2 (Type)
Regular Honors AP IB
11th Grade: Course 2 (AP exam)
11th Grade: Course 2 (AP exam score)
11th Grade: Course 2 (AP exam - scheduled date)
M-D-Y
11th Grade: Course 3 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
11th Grade: Course 3 (Title)
11th Grade: Course 3 (Type)
Regular Honors AP IB
11th Grade: Course 3 (AP exam)
11th Grade: Course 3 (AP exam score)
11th Grade: Course 3 (AP exam - scheduled date)
M-D-Y
11th Grade: Course 4 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
11th Grade: Course 4 (Title)
11th Grade: Course 4 (Type)
Regular Honors AP IB
11th Grade: Course 4 (AP exam)
11th Grade: Course 4 (AP exam score)
11th Grade: Course 4 (AP exam - scheduled date)
M-D-Y
11th Grade: Course 5 (Name)
[Math] Algebra I [Math] Algebra II [Math] Calculus [Math] Computer Science [Math] Geometry [Math] Mathematics I [Math] Mathematics II [Math] Mathematics III [Math] Statistics [Science] Applied Science [Science] Biology / Life Sciences [Science] Chemistry [Science] Computer Science [Science] Earth and Space Sciences [Science] Engineering [Science] Integrated Science [Science] Integrated Science 1 [Science] Integrated Science 2 [Science] Integrated Science 3 [Science] Interdisciplinary Sciences [Science] Physics Other
11th Grade: Course 5 (Title)
11th Grade: Course 5 (Type)
Regular Honors AP IB
11th Grade: Course 5 (AP exam)
11th Grade: Course 5 (AP exam score)
11th Grade: Course 5 (AP exam - scheduled date)
M-D-Y
Provide us a list of up to 5 of your extracurricular activities, hobbies, and/or outside of school responsibilities, years involved, and a brief description. Please prioritize listing activities that highlight your passion in science. Activity Title Years Involved Brief Explanation (150 words max) Activity #1 Activity #2 Activity #3 Activity #4 Activity #5
Activity #1: Years Involved
Activity #1: Brief Explanation (150 words max)
Activity #2: Years Involved
Activity #2: Brief Explanation (150 words max)
Activity #3: Years Involved
Activity #3: Brief Explanation (150 words max)
Activity #4: Years Involved
Activity #4: Brief Explanation (150 words max)
Activity #5: Years Involved
Activity #5: Brief Explanation (150 words max)
List any Leadership Positions/Awards you have received and provide a brief explanation. (50 words max) Brief Explanation (50 words max) Position/Award #1 Position/Award #2 Position/Award #3 Position/Award #4 Position/Award #5
Leadership Position/Award #1
Leadership Position/Award #1: Explanation
Leadership Position/Award #2
Leadership Position/Award #2: Explanation
Leadership Position/Award #3
Leadership Position/Award #3: Explanation
Leadership Position/Award #4
Leadership Position/Award #4: Explanation
Leadership Position/Award #5
Leadership Position/Award #5: Explanation
We've seen your grades and activities in your application; now go beyond this and tell us your story. What is it that you think we should know about you?
*
What do you want to accomplish in LA-HIP, and how does it align with your interest in science?
*
Describe a time when you faced a challenge or setback. How did you handle it, and what did you learn about yourself from the experience?
*
LA-HIP is a yearlong internship where participants complete a 8-week biomedical summer research training and internship with a faculty member at The Saban Research Institute of Children's Hospital Los Angeles, in addition to SAT preparation courses, academic enrichment workshops, as well as a yearlong college counseling program. What part of the summer internship are you most excited about?
*
Provide accurate contact information for at least one but no more than two science or math teachers from your school who will complete the "Application Evaluation" form on your behalf. An email will automatically be sent to your recommender(s) once you complete the following and save the page. Make sure that they submit the recommendation no later than February 2, 2025 23:59:59. Please make sure that each recommender has agreed to write you a letter before you add the contact information. First Name Last Name Relationship Work Phone Work Email 1. 2.
IMPORTANT! You are required to submit your current transcript with your grades through Fall 2024 as a part of your application. Please upload your unofficial or official transcript here (pdf or jpg required):
*
Having Uploading Issues? If you are not able to upload your transcript, please contact
Danielle Nunez for further instruction.
Does the High School Transcript provided above include your grades for the Fall 2024 semester?
*
Yes No
If you have taken any college/university classes, please upload your unofficial or official transcript here (pdf or jpg required):
Having Uploading Issues? If you are not able to upload your transcript, please contact
Danielle Nunez for further instruction.
I certify that the answers given by me to the foregoing questions and statements are true, correct, and without omissions. I authorize LA-HIP to investigate and/or verify the foregoing information and any other information, which might assist them in determining my qualifications for the internship.
*
Submit
Save & Return Later