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 2022-2023 academic year?
When is your expected graduation date (month/year)? * School * Discipline * Degree Program * Are you a dual degree student? * Availability *
Fellows are expected to participate in Fellowship activities throughout the year (April 2022-April 2023). 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.
Keep in mind, due to COVID-19, projects will be subject to remote or virtual requirements, as dictated by the best public health science.
Population Demographic & Needs *
Please describe the specific population you wish to impact with your proposed community service project, including demographic information, the health disparity(ies) you will address and, details regarding your community needs assessment. (suggested word count: 150)
Proposed Community Agency(ies). Include a brief description of your relationship to the site, if applicable. * Proposed Community Service Project *
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)
How do you plan to center your efforts around those who will benefit the most from this collaboration? *
As a Fellow, you are partnering with the community to help them achieve health and wellness. How do you plan to center your efforts around those who will benefit the most from this collaboration? For example, how might you ensure that those with lived experience are included in developing and testing your idea? (suggested word count: 200)
What evidence do you have that your project could be successful? *
Examples may include community-based evidence, pointing to conversations/ experiences you’ve had with leaders and/ or members of the community, pointing to a similar model and /or research-based evidence. (suggested word count: 200)
Project Evaluation Methods *
Fellows design their project with the outcomes in mind. What do you hope will be different as a result of your intervention and how will you know if you achieve this change? Knowing that your evaluation strategies may shift as the project is developed, please indicate which methods you will consider using throughout the year to evaluate progress toward goals and final outcomes. 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. (Suggested Word Count: 200)
Project Time Frame *
Fifty of the 200 hours are for project planning and can begin immediately upon selection. The remaining 150 hours is required to be spent in direct, face-to-face community service. Virtual or remote contact is also considered direct service.
Please prepare a list of how you will apportion your 150 direct service hours throughout the Fellowship year. Direct service hours can begin no earlier than May 1 and need to be complete by May 1 the following year. Activities are concrete action steps conducted throughout your project to achieve your goals. Include a projected date for each action as well as an estimate of how many hours it will take. Include time you will spend to understand the community and build upon the community assessment you made when developing your application. This estimate is a foundation upon which to develop your project. 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. (suggested word count: 150)
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 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, Phone, Job Title and Organization * 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.
Terms * In the event public health guidelines do not permit in person events, events will be held virtually
• Perform at least 200 hours of service
• Attend the Celebration of Service on April 2, 2022 in Raleigh and in March/April, 2023 (date to be determined)
• Attend an overnight orientation retreat April 9-10, 2022 in Davidson
• Attend a midyear retreat in the fall and monthly virtual webinars (dates to be determined)
How did you first hear about the Schweitzer Fellowship? (check all that apply)