APPLY First Name Email Address Mailing Address Last Name Phone Number City State ZIP Code Education
Will you be enrolled in a degree-granting program through April 2021?
What year in your degree program will you be during the 2021-2022 academic year? First Second Third Fourth Other Expected graduation date: For joint applications, please list your project partner's name: School: Baylor College of Medicine UTHealth - Medical School UTHealth - School of Public Health UTHealth - School of Dentistry UTHealth - GSBS UTMB - School of Medicine UTMB - GSBS Univ of Houston - Law Center Univ of Houston - Graduate College of Social Work Univ of Houston - College of Pharmacy Univ of Houston - College of Education Univ of Houston - Clear Lake Univ of Houston - Psychology Dept Houston Baptist University Texas Southern University Rice University Texas A&M School of Public Health Houston College of Law Other Discipline of Study: What applicant type best applies to you next year? Junior Fellow (undergrad) Senior fellow (grad student) Resident Fellow (resident physician)
Fellows are expected to participate in Fellowship activities throughout the year. Will you have significant clinical responsibility during the Fellowship year that may interfere with your ability to paticipate in the Fellowship?
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 Please describe the target population you wish to impact with your proposed commmunity service project, including demographic information. (suggested word count: 100) Proposed community agency/agencies (if a community agency has not yet been identified, please type TBD). Describe the community need for your project and how your project will support local and national health priorities. (suggested word count 150) Please describe your proposed community service project, including project goals and the actions you will take to meet these goals. Specifically detail the ways in which you hope to impact the target population identified in question 1. For example, what kinds of behavior changes do you wish community members to adopt as an outcome of your project? (Suggested word count: 350, see note below). What is the time frame for your project? Please consult application guidelines for specific program start and stop dates. (Suggested word count 150) Describe the avenues you will explore to sustain the project beyond your time as a Fellow. (Suggested word count 200) How will you evaluate the project to determine whether your goals were met? How will you know if your project has been successful or verify your results? Personal and Professional Information as it Relates to the Fellowship Activities What is your motivation for applying to the Albert Schweitzer Fellowship? Please consider the community service project, participation in Fellowship activities, and being a part of a multidisciplinary group. (Suggested word count 200) 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)
Please discuss the following: (suggested word count 600)
Ways in which your participation as a Schweitzer Fellow would be meaningful to your personal and professional development
Skills and experiences you will bring to the Fellowship
What it might mean for you to belong to an alumni network of "Fellows for Life"
Any unique, personally important, and/or challenging factors in your background, and how they have influenced your goals and preparation for your career
Please list the contact information for at least three references.
At least one reference should be a faculty member from your school who could serve as your Academic Mentor for the Schweitzer Fellowship. For each reference, describe your relationship in one sentence and include contact information such as telephone number and email address. Reference 1/Proposed Faculty Member Reference 2 Reference 3 (Optional) Please list someone at your proposed site who could serve as a Site Mentor or who has been your site contact. Inlcude telephone number and email address. If a possible Site Mentor or contact has not yet been identified, please type TBD.
Please select the Track that best fits your proposed project. If your project doesn't fit any of these, select "Open Track".
Please upload your resume as a PDF. Please upload your letter of recommendation as a PDF file (optional). Note: if you choose not to submit a letter at this time with your application but still want to submit one, you may have your letter writer submit their letter directly to email@example.com.
If selected to serve as a Schweitzer Fellow, I will commit to the following (Please select all boxes to indicate that you agree.)