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2025 ENRICH Trainee Application

Please complete and submit the form below. Once received, we will send you the password needed to access the ENRICH Research Experiences page to view available projects.

If you have questions, please contact Eve Phillips at UABENRICH@uabmc.edu.

ENRICH Trainee Application – 2025

Please provide your legal name *

Please provide your legal name

First

Middle

Last

Please provide your UAB/Samford email address *

Current mailing address *

City *

State *

Zip code *

Phone number (example: (XXX) XXX-XXXX) *

Citizenship *

United States Citizen

Permanent Resident, Green Card #:Permanent Resident, Green Card #:

Gender Identity *

Race *

Are you Hispanic or Latino? *

Yes

No

Do you have a disability? *

Yes

No

Do not wish to provide

Are you from a disadvantaged background? *

Yes

No

Do not wish to provide

Undergraduate Institution Name *

Institution City/State *

Degree conferred *

BA

BS

OtherOther

Graduation Date (MM/DD/YYYY) *

Current Degree Program * Current Degree Program

HSOM Students – do you plan on serving as an Orientation Leader? (Non-MD students, please select last option) *

Yes

No

N/A, not an MD student

Current Institution (UAB or Samford?) *

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