Applicant Information Address (street, city, and zip) * Phone * Program Year * 1st 2nd 3rd 4th Other
What year in your degree program will you be during the 2021-2022 academic year?
When is your expected graduation date? * School * Discipline * Degree Program * Are you a dual degree student? * Availability *
Fellows are expected to participate in Fellowship activities throughout the year (April 2021-April 2022). Will you have significant academic/clinical responsibility during the Fellowship year that may interfere with your ability to participate in the Fellowship?
Other Commitments *
Please indicate any times you anticipate being out of the area and/or unable to participate in Fellowship activities for reasons other than those listed above.
Project Information Population Demographic & Needs *
Please describe the specific population you wish to impact with your proposed community service project, including demographic information and the community need(s) your project would address. (suggested word count: 150)
Proposed Community Service Project * Keep in mind, due to COVID-19, 2021-22 projects will be subject to remote or virtual requirements, as dictated by the best public health science.
Please describe your proposed community service project, including the following: project goals, and possible activities to meet these goals; intended outcomes you hope to see for the participants; if you are proposing to continue an existing program, please briefly describe how you might expand or build upon it. (suggested word count: 400) Proposed Community Agency (or agencies) * Project Evaluation Methods *
If you are accepted as a Fellow, will be asked to design your project with the outcomes in mind. How do you plan to evaluate your project’s impact? Knowing that your evaluation strategies may change as the project is developed, please indicate which methods you will consider using throughout the year to evaluate your project’s effectiveness and determine how well your goals were met. (Suggested Word Count: 200)
For example, Fellows often conduct baseline and follow-up validated surveys to track behavior change, provide journals to participants to record progress with individual goals, or identify other ways to gauge how well community members were able to make and sustain healthy changes as a result of the project. Clinical based projects track disease specific changes using biomedical data.
Project Time Frame *
Once Fellows are selected, 50 of the 200 hours are for project planning (25 for each partner). The remaining 150 hours is required to be spent in direct, face-to-face community service (75 for each partner). Virtual or remote contact is also considered direct service.
Please prepare a list of how you will apportion your direct service hours throughout the Fellowship year. Keep in mind, direct service hours can begin no earlier than May 1 and need to be complete by May 1 next year. It is important to be specific in terms of frequency of engagement with your population and projected start date of direct service. To ensure you can reach the target number of hours required (200 total), calculate your hours per workshop/activity and schedule when it best fits your academic calendar. It is understood this is an estimate but this builds a foundation upon which to develop your project. (suggested word count: 150)
Be specific regarding the logistical aspects of your project. For example, list the number of sessions in a workshop, length of each session, number of participants per workshop, total number of workshop series, etc. in as much detail as possible. Sustaining the Project *
Describe the avenues you will explore to sustain the project beyond your time as a Fellow. (suggested word count: 200)
Personal & Professional Information as it Relates to Fellowship Activities Inspiration for Your Project *
Considering that there are many different types of community service projects a Fellow could design, what inspired you to develop your particular project idea? (suggested word count: 200)
Tell me about an obstacle you overcame. *
(suggested word count: 150)
What would you hope to learn (knowledge or skills) during your fellowship year? *
(suggested word count: 75)
Personal Statement *
Please include anything about your personal and professional background as well as your motivation for applying to the Schweitzer Fellowship that you would like to share with the selection committee. (suggested word count: 800)
Proposed Faculty Mentor Name, Email and Phone * Please describe your relationship with Proposed Faculty Mentor in one sentence * Proposed Site Mentor Name, Email and Phone * Reference 1/Academic Reference Name, Email and Phone *
(separate from the faculty mentor)
Please describe your relationship with Reference 1/Academic Reference in one sentence * Reference 2/Personal Reference Name, Email and Phone *
Volunteer supervisor (current or past), previous employer, or general personal reference.
Please describe your relationship with Reference 2/Personal Reference in one sentence: * Upload your Resume *
Please upload your resumes in PDF format.
How did you first hear about the Schweitzer Fellowship? (check all that apply)