Single Application 26 – 27 Single Applicant From 2026 - 27DemographicsFirst NameLast NameAddressAddress Line 1Address Line 2CityStateZip CodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwePhone Number EmailEducationWill you be enrolled in a degree-granting program through April 2026? Yes NoWhat year in your degree program will you be during the 2025-2026 academic year?When is your expected graduation date?SchoolDisciplineDegree ProgramHow 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.INTEREST AREAS & PERFORMANCE MEASURESSome descrEach 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. ASF also uses a results framework, so that activities you conduct are directed towards a specific goal. Below, you will share two ideas that interest you. For each, tell us the need, performance measure, project idea, possible community partner site(s), and a way that you could address this need through a fellowship project. 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. iption about this sectionProject Idea #1A) What topic would your project address? B) Describe a potential strategy you might use to address this topic.C) Why do you care about this social issue and what is your relationship to those who are impacted by this need? D) Name 1 or more possible community site partners and describe why you believe this project would align with their mission and goalsE) 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? Project Idea #2A) What topic would your project address? B) Describe a potential strategy you might use to address this topic.C) Why do you care about this social issue and what is your relationship to those who are impacted by this need? D) Name 1 or more possible community site partners and describe why you believe this project would align with their mission and goalsE) 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 ACTIVITIESSome description about this sectionWhat inspired you to participate in the Schweitzer Fellowship?Tell us about a time in which you failed or faced a major obstacle. How did you respond?What practices do you use to learn and improve your effectiveness?What would you hope to learn (knowledge or skills) during your fellowship year? Optional- Please include anything else about your personal and professional background that you would like to share with the selection committee INTERVIEW SCHEDULINGSome dInterviews will be held on January 29th and 30th virtually and will last about 30 minutes (or 45 minutes for partnered applicants). Please indicate your availability here by checking any timeslot that you can NOT attend. We will automatically assign interview timeslots and notify you around January 24th if you’ve received an interview and when the interview will take place. escription about this sectionAgain, select options that do NOT work; do not select options that you would be available.Option 1Wednesday, January 29th (5:00-6:30pm)Wednesday, January 29th (6:30-8:00pm)Thursday, January 30th (5:00-6:30pm)Thursday, January 30th (6:30-8:00pm)REFERENCES, INCLUDING ACADEMIC MENTORSome description about this sectionPlease provide the names and contact information for two individuals. For Reference #1, applicants should have identified a faculty member who agrees to support you during the year as outlined in the Academic Mentor Agreement (found on our website under “Become a Fellow). For Reference #2, include anyone else who can attest to your character, either due to personal, academic, or work experience. You do NOT need to submit letters of recommendation from either person, however, we may contact them for a reference check. Refernce 1 - Academic MentorSome description about this sectionFirst NameLast NamePhone NumberEmailReference 2 Some description about this sectionFirst NameLast NamePhone NumberEmailAGREEMENT TO ASF REQUIREMENTSBy 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 [or possibly less if a partner project] towards planning and implementing the project (June 2025-April 2026). 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 Orientation (April 12-13, 2025) and 80% or more of the monthly meetings, completing the service hours, conducting Pre/Post-Surveys, and submitting a Final Report.Do you agree to these requierments? Yes NoSubmit Form