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Faculty Mentor Fellowship Application
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Applicant Information Form
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Step
1
of 7
program? describes are
Please make sure to complete the form in its entirety before submitting, as there is no option to save progress.
Primary Contact Information
Provide information for the person to be contacted about your application.
Name
*
First
Last
Phone
*
Email
*
Title
*
What is the name of the college or university where you are employed?
*
For which academic department(s) do you teach or conduct research?
*
How many years have you been a part of the faculty at your current institution?
*
This will be my first year
1 - 3 years
4 - 7 years
8 - 10 years
10 - 19 years
20+ years
Full-time or adjunct?
*
Full-time
Adjunct
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How many students do you plan to engage in your research project?
3
4
5
Which best describes the project you are proposing for this program?
*
This will be a first-time project
This project is part of an ongoing effort
What are your total years of experience conducting research projects involving undergraduates as part of your research team?
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Statement of interest
*
Click or drag a file to this area to upload.
Explain your motivation for being a mentor, relevant expertise, and commitment to community-based research and student mentorship. (One page maximum)
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Curriculum vitae (CV) highlighting relevant experience.
*
Click or drag a file to this area to upload.
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Research Proposal (Three pages maximum)
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Click or drag a file to this area to upload.
Complete all 13 sections listed under Research Proposal in the application instructions.
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Budget (Complete and upload the Community Research Grant Budget Template)
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Include an Itemized budget for all program-related expenses. Your budget must include the travel expenses for the Washington DC Social Justice Summit of up to $800 per person (paid for by the grant).
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5.Signature of Authorized Organizational Representative (Use the AOR Approval Form)
*
Click or drag a file to this area to upload.
Your institution’s AOR must include a statement indicating that they have reviewed and approved your proposal and budget.
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Submit Application