2017 CGH University Scholar Award Application

Application Deadline: ALL MATERIALS ARE DUE 20 JANUARY 2017

Scholar Candidate Interviews: 17 FEBRUARY 2017

Awards Announced: 28 FEBRUARY 2017

Award Conditions:

US Department of State Travel Warnings: No work or research in countries with an active US Department of State Travel Warning or other UVa travel restrictions.

University of Virginia International Student Travel Policy: All CGH programs and participants must adhere to the policy which will provide the most up-to-date information on 1) what restrictions apply, 2) under what circumstances and how students can request an exemption from the policy, and 3) requirements to register with ISO.

Institutional Review Board (IRB): It is your responsibility to comply with any UVa Institutional Review Board requirements which may apply. Protocols should be submitted to the IRB by 1 April 2017.

CORE: All undergraduates, and students matriculated in a 4+1 program must complete the CORE (Cultural Orientation Reflection and Engagement) required course.

Funds Disbursement: Pending compliance with all award requirements, approved funds will be issued via SIS on 1 June 2017. Funds will be delayed if requirements are not completed by 1 May 2017.

UVa Faculty Mentor Funds: CGH will provide support funds to faculty for projects which are fully funded by the Center for Global Health.

If you are a student in the School of Medicine: Eligible proposals should be conducted in School of Medicine elective and research sites (Tanzania, Uganda, South Africa, Rwanda, and Guatemala). Students involved in research which falls under HSR IRB purview must be working as a sub-investigator under an existing protocol led by a UVA faculty member or must work under an established protocol at a partner university.

I certify I have read and understand all of the conditions outlined above. If award requirements are not completed on time, I understand that my award funds will be delayed. *

Yes

The Center for Global Health accepts applications from individuals, partnerships, and teams.

Please submit ONE application to represent your project.

Please list all applicants in the text fields below.

Additional documentation, including letters of recommendation, can be sent directly to ctrglobalhealth@virginia.edu.

Full Name *

First Name Last Name

E-mail *

Cell Phone *

- Area Code Phone Number

UVa School *

Major(s) and Minor *

Year of Graduation *

I am part of a fifth year program such as Batten, MPH, or Curry *

In State or Out of State student *

I will study abroad in Spring semester 2017. *

I may study abroad in Fall semester 2017. *

Additional Team Members

Please provide the full names, email, phone, school, and major/minor, year of graduation, etc. for each additional team member in the box above

UVa Faculty Mentor

UVa Faculty Department and Title

E-mail

Phone Number

- Area Code Phone Number

Partner Site Contact

E-mail

Phone Number

- Area Code Phone Number

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Descriptive Project Title

Country of Interest

Please submit a brief cultural and environmental analysis of your site(s). No more than 1 page. Please focus on the cultural and physical differences you will encounter and describe your plans to adapt.

Anticipated Itinerary and Dates of Project

Previous coursework related to your project. Include possible post-award related courses including independent study:

Project Narrative

Describe your project in no more than 2 pages. Please include the following:

1) Background

2) Research Question/Rationale

3) Methodology

4) Expected Outcomes

5) References/Citations

6) Personal Statement (1 paragraph)

~ References and the personal statement can exceed the 2 page limit.

Upload Project Narrative

Important: International Studies Office Compliance. Each student applicant should visit Student Projects Abroad, login in with your netbadge ID, create a profile for your proposed project abroad, and specifically complete the Travel Form for Student Research and Learning Abroad which is required for all international funding applications. Please download and complete the PDF form and email to projectsabroad@virginia.edu.

The ISO Travel Form is a required component of your CGH application. Travel Forms must be completed and delivered to ISO by the CGH Scholar Award Deadline.

Proposals which do not include a completed ISO Travel Form for Student Research and Learning Abroad delivered to ISO, will not be reviewed.

Please upload the following REQUIRED documents in support of your application:

1) Budget- Include travel and living expenses, vaccines, visas, language courses, and any project costs.

2) CV or Résumé

3) Letter of Support from a UVa faculty mentor

4) Letter of Support from your in-country mentor or partner

5) Cultural and Environmental analysis

Upload Budget

Upload CV or Résumé

Letter of Support from UVa faculty mentor

Letter of Support from in-country mentor or partner

If you have any questions you may call 434-243-6383 or email ctrglobalhealth@virginia.edu.

I have provided all of the following and my application is complete: *

Project Narrative Budget CV Letter of Support from a UVa faculty mentor Letter of Support from in-country mentor or partner ISO Travel Form Cultural and Environmental Analysis

2017 CGH University Scholar Award Application

Applicant Information

Mentor Information

Project Information

Supporting Documents

Application Checklist