Applicant Contact & School Permanent Email
Please provide a permanent Email address (such as gmail), if different from Preferred Email.
Phone * Enrollment * Yes No
Will you be enrolled in a degree granting program through April 2023?
Program Year * 1st 2nd 3rd 4th Other
In what year of your degree program will you be during the 2022-2023 academic year?
Expected graduation date? * Your School * Your Area of Study * Degree Program * Availability *
Fellows are expected to participate in Fellowship 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? If yes, please explain.
Project Information Target Demographic & Needs *
Please describe the target 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 *
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) *
Proposed community agency (or agencies) project site (if a community agency has not yet been identified, please enter TBD).
Project Evaluation Methods *
If you are accepted as a Fellow, once your project is in process you will be expected to evaluate your project’s impact. Knowing that your evaluation strategies may change as the project develops, please indicate what methods you have thought about using throughout the year to evaluate your project’s effectiveness and determine how well your goals were met. Please give some specific outcomes that you hope to achieve from the project. Please consult the Program Director for additional information (suggested word count 200).
Project Timeframe *
Bearing in mind that the majority of your service hours should be spent in direct, face-to-face community service, how would you apportion your time throughout the Fellowship year? Please include a proposed start and end date (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).
Applicant 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)?
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).
Reference 1 (Proposed Faculty Mentor): * Reference 2: * Reference 3: * Site Mentor *
Please list someone at your proposed site who could serve as a Site Mentor or who has been your site contact. Include telephone number and email address. If a possible Site Mentor or contact has not yet been identified, please enter TBD.
Upload your Resume *
Please upload your resumes in PDF format.
Commitment to the Fellowship Terms *
As a U.S. Schweitzer Fellow I will be expected to fulfill the following responsibilities:
Develop and implement a community service project with a community-based organization. The project is separate from any school course requirement and should be completed by June 1, 2023 if possible.
Perform about 200 hours of community service that seeks to address the unmet health needs of underserved individuals and communities. At least half of these hours should be direct face-to-face service with the targeted population.
Submit a completed project description form by June 15, 2022 that includes a detailed description of your project, the evaluation and sustainability plan and is signed by all faculty and community mentors.
Attend the Orientation retreat in early April (date TBD).
Attend the Celebration of Service in May, 2022 (date TBD) to honor the current Fellows and welcome the class of 2022-23.
Attend and actively participate in ALL monthly meetings of the Fellows.
Submit a report by the first of each month to the Program Director and your Academic and Site Mentors that lists and reflects upon the previous month’s activities. If project activities were not conducted, you must still submit a report and indicate as such.
Actively participate in the planning and implementation of the group outreach project.
Attend an individual progress meeting with the Program Director mid-way through the Fellowship year.
Attend and participate in at least one recruiting presentation informing students and faculty at Bay Area academic institutions about the Schweitzer Fellowship Program.
Create a poster to be displayed at the Celebration of Service event at the conclusion of your Fellowship year and a reflection page for use at that event. Attend that Celebration of Service in May 2022 and give a brief presentation about your project.
Submit a final report by June 15, 2023 if possible.
Complete a pre- and post Fellowship survey and insure your site mentor also completes a survey.