PLEASE BE AWARE THAT YOU WILL NOT BE ABLE TO SAVE YOUR PROGRESS, SO PLEASE PREPARE ALL OF YOUR ANSWERS AND UPLOADABLE FILES IN ADVANCE.

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2/26/2018 PhD Works Spring 2018 Application PhD Works Spring 2018 Application Your email address (lyl.tomlinson@

1 2/26/2018 PhD Works Spring 2018 Application PhD Works Spring 2018 Application Your address will be recorded when you submit this form. Not lyl.tomlinson? Sign out * Required Spring 2018 Application Please complete the information below in order to apply for the academic cycle of the PhD Works award program. At the end of this application, you will be asked to upload three PDF files: (a) a CV, (b) your short answer document, and (c) a proposed budget. For details on what is required, review the application website at which includes a preview of the application questions requested in this Google form. PLEASE BE AWARE THAT YOU WILL NOT BE ABLE TO SAVE YOUR PROGRESS, SO PLEASE PREPARE ALL OF YOUR ANSWERS AND UPLOADABLE FILES IN ADVANCE. If you have any questions on the application, contact us at Lyl.Tomlinson@stonybrook.edu 1. First Name * 2. Last Name * 3. SBU Student ID Number * 4. Institutional Address * 1/5

5. Preferred E-mail Address * 6. Preferred Phone Number * 7. SBU Graduate Program * 8. What is your G level as of Spring 2018? * Mark only one oval. G1 G2 G3 G4 G5 9.

2 5. Preferred Address * 6. Preferred Phone Number * 7. SBU Graduate Program * 8. What is your G level as of Spring 2018? * Mark only one oval. G1 G2 G3 G4 G5 9. What is your expected graduation date? * (Month and Year) Demographics PhD Works Commitment to Diversifying the Professional Workforce PhD Works aims to assist SBU PhD students prepare for careers within the professional workforce (broadly defined). An additional goal of the program is to diversify the future professional workforce by fostering the development of PhD students from underrepresented groups or people who can demonstrate they have overcome a disadvantage or impediment to success in higher education. Students whose participation in PhD Works would advance this goal, either through experience or demonstrated commitment, are strongly encouraged to apply and will qualify for limited professional development funds of up to $ /5

3 10. What is your citizenship? * Mark only one oval. U.S. Citizen Non-U.S. Citizen Permanent Resident (e.g., greencard holder) Non-U.S. Citizen on temporary visa Prefer not to answer 11. What is your gender? * (e.g., male, female, transgender, other non-binary, prefer not to say, etc) 12. What is your race and/or ethnicity? * Please check all that apply. Check all that apply. White Non-Hispanic Hispanic or Latino/a Asian Pacific Islander or Native Hawaiian Black or African American Native American or American Indian or Alaskan Native 13. If you identify with any of the following groups that are underrepresented in various fields or have demonstrated commitment to diversifying the professional workforce in one or more of these areas, and you believe that your participation in PhD Works would help advance our diversity goal, please select all of the following that apply. This question is optional. Check all that apply. Gender identity LGBTQ+ Women in science Disability Socioeconomically disadvantaged background (e.g., Pell eligible) Veteran Ethnic/racial minority Commitment to advancing diversity (please explain in next question) Prefer not to say 3/5

4 14. If you would like to explain or expand upon your response to the previous question, please use the box below. If you would prefer to communicate about these issues through another method, please let us know, and we can contact you directly. Application Materials Please upload below a CV/resume that highlights your career exploration activities, skills and research-related accomplishments that may be relevant to your career development. 15. Please upload your CV (PDF) here: (2 page maximum) Please upload below a document that addresses the following short answer questions: (1.) Briefly describe how the skills, knowledge or experience you hope to gain during the funded activity could potentially benefit your career development. (250 words maximum) (2.) State the ways in which you believe you will contribute to the diversity on campus or your field of study/interest, in your long term goals to carry out your social responsibility as a future leader and/or educator. Additionally, please tell us how the award would help you realize these goals. It would be helpful to include any information related to their academic/social experience relevant to this mission. (500 words maximum) 16. Upload your short answer document (PDF) here: Please upload a budget detailing the requested funds. The total budgeted amount may not exceed $750. In addition to a detailed budget, please include original receipts for past expenses and/or documentation for any estimated expenses, all in one combined PDF file. 17. Upload your budget document (PDF) here: * Thank you for applying to PhD Works! You will receive a response from us after your application is processed. If you have 4/5

5 any questions about your application, please A copy of your responses will be ed to Powered by 5/5

PLEASE BE AWARE THAT YOU WILL NOT BE ABLE TO SAVE YOUR PROGRESS, SO PLEASE PREPARE ALL OF YOUR ANSWERS AND UPLOADABLE FILES IN ADVANCE.

PLEASE BE AWARE THAT YOU WILL NOT BE ABLE TO SAVE YOUR PROGRESS, SO PLEASE PREPARE ALL OF YOUR ANSWERS AND UPLOADABLE FILES IN ADVANCE. 6/12/2018 PhD Works Summer 2018 Application PhD Works Summer 2018 Application Your email address (lyl.tomlinson@stonybrook.edu) will be recorded when you submit this form. Not lyl.tomlinson? Sign out *