Applicant Information Email * Phone * Education Enrollment * Yes No
Will you be enrolled in a degree-granting program through April 2023?
Program Year * First Second Third Fourth Other
What year in your degree program will you be during the 2022-2023 academic year?
Expected graduation date? * Your School * Auburn University (Nursing; Pharmacy; Social Work; or Special Education, Rehabilitation and Counseling) Samford University, College of Health Sciences UAB School of Dentistry UAB School of Health Professions UAB Heersink School of Medicine UAB School of Nursing UAB School of Optometry UAB School of Public Health University of Montevallo Other- Students from other schools/departments will be considered as funding allows
Please select your school; if Other, include the name below next to your discipline
Your Discipline * Degree Program * Availability *
Fellows are expected to participate in Fellowship activities throughout the 13-months (March 2022 – April 2023). To achieve the 200+ hours of service required, it will take an average of 4-5 hours/week. How do you plan to balance your commitment to ASF service hours while maintaining successful progress in your academic program?
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.
Each year, ASF of Alabama seeks to be responsive to community needs while also honoring the interests of applicants. Research shows that health outcomes are a product of health behaviors, clinical care, social and economic factors, and the physical environment.
Which of the following are you most likely to address with your Schweitzer Fellowship project? Choose up to two (2).. *
If you select “other”, please describe it below.
Share with us about two of your interests. For each, tell us a topic, project idea, possible community partner site(s), and way that you could address this need through a fellowship project. *
Here, please describe two ideas – one in A-E and the second in F-J. You are not committing to undertake either of these ideas and you do not need a commitment yet from the site partner listed; it’s just a way to see how you think about community needs.
a) Specific need that is relevant in your community [Up to 1 sentence]
b) Potential way that this problem (A) could be addressed [Up to 5 sentences]
c) Explain why this topic or population in need interests you [Up to 5 sentences]
d) Name 1 or more possible community site partners and describe why you believe this project would align with their mission and goals
e) How could you center your effort 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?
f) Specific need that is relevant in your community [Up to 1 sentence]
g) Potential way that this problem (F) could be addressed [Up to 5 sentences]
h) Explain why this topic or population in need interests you [Up to 5 sentences]
i) Name 1 or more possible community site partners and describe why you believe this project would align with their mission and goals
j) How could you center your effort 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?
Applicant Personal & Professional Information as it Relates to Fellowship Activities Inspiration for pursuing ASF *
What inspires you to participate in the Schweitzer Fellowship (suggested word limit – 1 paragraph)?
Personal Growth *
Tell us about a time in which you failed or faced a major obstacle. How did you respond? (Suggested word limit – 1 paragraph)
Learning Goals *
What would you hope to learn (knowledge or skills) during your fellowship year? (Suggested word limit – 1 paragraph)
Tell us about your personal experience with being part of a team (academic, extra-curricular, etc.) where you had to advance a project or task. How did you contribute to the team? (Suggested word limit – 1 paragraph)
Please include anything else about your personal and professional background that you would like to share with the selection committee (Suggested word limit – maximum of 3 paragraphs).
Please provide the names and contact information for two individuals who can attest to your character, either due to personal, academic, or work experience. You do NOT need to submit letters of recommendation from them. Rather, we may contact them for a reference check.
Phone * Email * Phone * Email * Resume/CV *
Please upload your resume (limit 2 pages)
Attestations Agreement to ASF Requirements *
By applying to ASF, you understand that successful progress in the program requires Fellows to identify a community site (by April), plan a project (by June), and conduct 200+ hours towards planning and implementing the project (June 2022-April 2023). You also understand that a background check will be run on all who are selected prior to beginning service hours. The stipend is contingent on meeting certain benchmarks throughout the program year, including attending 80% or more of the monthly meetings, completing the service hours, conducting Pre/Post-Surveys, and submitting a Final Report.
Agreement to Safety Precautions *
By applying to ASF, you understand that precautions related to COVID and other disease mitigation will be instituted to protect you and individuals at your community site. Fellows are encouraged to be fully vaccinated and will be asked to document full and up-to-date vaccination status per any CDC guidelines. Should a Fellow not wish to show evidence of vaccination, they will be asked to conduct a project virtually or to pursue recurring testing in order to ensure safety.