Application For BreakFree Fellowship

Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

In 2-3 sentences, explain why you are interested in this Fellowship*

In one or more paragraphs, share a time when you committed to doing something or accomplishing something in particular. What was it that you committed to? How did you demonstrate your commitment? What was the ultimate result?*

How did you hear about the BreakFree Education Fellowship?*

Please confirm that you are an IRAA/Second Look Grantee

Yes, I am an IRAA/Second Look GranteeNo, I am not an IRAA/Second Look Grantee

Are you interested in a full-time or part-time fellowship?

Full-timePart-time (approximately 10 hours per week)

For part-time fellowship: Generally, when would you be available to work part-time at your host site?

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Morning
Afternoon
Evening

For part-time fellowship: Briefly explain your availability (examples: lots of flexibility with notice, I work everyday until 2pm, I'm only available on the weekends, etc.)

Below, please attach your cover letter and resume. If you need assistance in writing a cover letter, please review this website.

Please upload your Cover Letter below.*

Please upload your Resume below.*

Optional: You may upload a Letter of Recommendation if you choose.

Please note:

All individuals must be fully vaccinated for COVID-19 by September 13th to be selected as a BreakFree IRAA Fellow.