Required Fields are marked with asterisks.

*First Name:
*Middle Name:
*Last Name:
*Birth Date:
*UKID:
*Gender:	Male Female
*Race:	White, Non-Hispanic Black, Non-Hispanic American Indian/Alaska Native Hispanic Asian/Pacific Islander Latino Unknown
*Email Address:
Campus Address 1:
Campus Address 2:
Campus City:
Campus Zip:
Campus Phone:			(859) 123-4567
*Home Address1:
Home Address2:
*Home City:
*Home State:
*Home Zip:
*Home County:
*Home Phone:			(859) 123-4567
*Enrollment Status:	Freshman Sophomore Junior Senior
Graduation Date:
College Major:
Current GPA:			Format:(0.0)

UK Programs Previously Participated

	B4B Summer Program
	Gaines Scholar
	UK Honors Program
	Freshman Summer Program(FSP):
	UK Undergraduate Research Program:
	UK Young Researchers Program:

* Research Interest?

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After submitting your registration information you will be redirected back to the UKURP home page. At that time your information will have been submitted to the Office of Research Assessment.