Are you applying with a partner? * No Yes Applicant's Personal Information and Education Applicant: Phone * Applicant: Enrollment * Yes No
Will you be enrolled in a degree-granting program through April 2021?
Applicant: Program Year * First Second Third Fourth Fifth Sixth
What year in your degree program will you be during the 2020–2021 academic year?
Applicant: What is your school? * Applicant: What is your discipline? * Applicant: What is your degree program? * Applicant: Availability *
Fellows are expected to participate in all Fellowship activities through the year (April 2020 – April 2021). This includes attendance at the overnight orientation retreat (April 17-18, 2020), one day mid-year Retreat (Sept or Oct, date TBD) and monthly meetings. Will you have significant academic, clinical or other responsibilities during the Fellowship year that will impact your ability to participate in the Fellowship? If yes, please explain.
The Schweitzer Fellowship experience is centered around each Fellow’s Schweitzer project. Schweitzer projects are 200 hours and provide a direct service to an underserved population. The project must fill an unmet need in the community and improve participants’ quality of life. Projects are housed at a local community agency, clinic, school or non-profit organization.
Please describe the community need(s) your project would address, as well as the target population. *
(Suggested word count 150)
Please describe your proposed community project. *
Include the following: project goals, possible activities to meet these goals and 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) Please describe why you decided to pursue this specific project. *
(Suggested word count 200)
What evidence do you have that such a project could be successful? *
Examples may include community-based evidence, pointing to conversations you have had with leaders and members of the community; practice-based evidence, pointing to a similar model in another location; and/or research-based evidence, pointing to scientific literature demonstrating the effectiveness of your proposed approach.
(Suggested word count 400) What is your proposed community project site? * If you are accepted as a Fellow, once your project is formed, you will be asked to evaluate your project's impact. Knowing that your evaluation strategies may change as the project is developed, please indicate what methods you have thought about using to evaluate your project's effectiveness and determine how well your goals were met. *
For example, Fellows have often conducted baseline and follow-up surveys, provided journals to participants to record progress with individual goals, held periodic discussions with participants, or identified other ways to gauge how well community members were able to make and sustain healthy changes as a result of the project.
(Suggested word count 200) Bearing in mind that at least half of the 200 project hours need to be spent in direct, face-to-face contact with project participants, how would you apportion your time throughout the Fellowship year? In addition, please include a proposed start and end date. *
For example, if you plan to meet weekly with your target population throughout the year, how many meetings would be required to fulfill direct service requirement? Be sure you have given some thought to the logistical aspects of this part of your project.
Describe the avenues you have considered as a way to sustain the project beyond your time as a Fellow. * Personal & Professional Information Applicant: 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)
Applicant: Personal Statement: What is your motivation for applying to the Schweitzer Fellowship? What do you hope to gain from this experience? What has led you to apply for this program? *
(Suggested word count 800)
Applicant: Please write a two-sentence description of yourself and your proposed project, including an introductory line of your name and your school/program. If you are selected as a Fellow, this may be posted on the Fellowship website and in press releases. Note that you will be able to edit this throughout the Fellowship year if you would like. *
Example: Elizabeth Salisbury, Rush University College of Medicine. Elizabeth proposes to develop and launch prenatal classes for pregnant teens at the Infant Welfare Society. The goal of the project is for participants to develop a birth plan and to build a social network they will turn to for emotional support during the first year after their babies are born.
Applicant: Proposed faculty mentor *
This individual must hold a faculty position in your program of study and be willing to support you through the Fellowship experience, if you are selected. Please list name, title, email and phone. Describe your relationship to the proposed faculty mentor.
Applicant: Proposed community site mentor *
This individual must hold a leadership role at your proposed community site. Please list name, role, email and phone. Describe your relationship to the proposed community site mentor.
Applicant: Please list the name, telephone number and a brief description of your relationship to two people who could serve as references for you. Consider individuals who can speak to your leadership skills and/or potential. * Commitment to the Fellowship Terms *
If selected to serve as a Schweitzer Fellow, I/we will commit to the following:
a) perform at least 200 hours of service;
b) attend an overnight Orientation Retreat (April 17-18, 2020);
c) attend a one day mid-year Retreat (Sept or Oct, date TBD);
d) attend monthly Fellowship meetings;
e) present at the Celebration of Service in April 2021.