1 The Global Health Initiative at the UIC School of Public Health is now accepting applications for the The competition will assist graduate students with travel expenses associated with an international field experience. Funds are available to support several students during the AY 2017-2018 year (includes Summer 2018). The honors the memory of Dr. Douglas James Passaro, Associate Professor of Epidemiology at the University of Illinois, Chicago and Attending Physician in Infectious Diseases at the UIC Hospital from 2001 to 2005. The award reflects his intense interest in addressing international public health problems worldwide through his work in Africa during his service in the Peace Corps and through his continued work in Latin America while at UIC. The fund is intended to provide support to graduate students for health-related, hands-on field experiences to carry on Dr. Passaro's important work in promoting global health that was interrupted by his untimely death at age forty-three. The most competitive applications will be from students seeking an experience that substantially broadens their understanding and application of public health in the world. Preference is given to proposals for projects in Latin America and Africa. Projects returning to locations where students have previously worked or studied are less preferred unless the applicant clearly demonstrates how the upcoming visit is substantially different from the applicant s previous experience. Eligibility Requirements The applicant must: Be a graduate or professional student at the UIC School of Public Health Have a cumulative GPA of 3.0 or better (4.0 scale) Should s/he be selected: o Purchase emergency evacuation insurance for travel abroad o Provide a post-experience report within two weeks of return o Attend the SPH Annual Research and Awards Day on April 6, 2018 o Prepare and present a poster on the field experience at the annual SPH Global Health Poster Competition within Research and Awards Day in April 2019 (date TBD). Application Packet The applicant must submit: A completed application form. A cover letter describing the proposed overseas field experience or project in detail and a statement, including expected learning objectives, of the potential or the proposed experience to enrich the applicant s exposure to global health. Students must also briefly describe previous international experience. The letter must include the name and contact information of the International Host Organization (2-page limit). A budget estimating total travel expenses. Please include any other sources of financial support that would be used to help offset the total cost of the experience. A letter (or email) from the Host Organization outlining the parameters and expectations for the field experience or project, if applicable. A letter from the applicant s UIC supervisor for the field experience vouching for the applicant s capacity for taking full advantage of this out-of-country field experience and stating her/his willingness to serve as a contact at UIC for the student while out of the country. A statement about foreign language proficiency (speaking, reading, writing) and language spoken at the proposed destination A copy of the applicant s UIC academic history (available from www.my.uic.edu)
2 Note: International students may not apply for projects in their own country, but a field experience in another country would be considered eligible. Timeline Application packets due Monday, February 26, 2018. Winners will be notified in early March. Awards will be presented at the SPH Annual Research and Awards Day on April 6, 2018. Please note: You must be in good financial standing to receive this award. Receiving this award may affect your financial aid package. We encourage you to contact Student Financial Aid Services to determine your financial standing. Please direct questions to: Erin Fitzpatrick, MPH, MPA Program Coordinator, Global Health Program 312-355-3219 Efitzpat@uic.edu Application Check List: Douglas Passaro Global Horizons scholarship application form o See page 3 of application for application form Budget o Budget breakdown estimating total travel expenses. Please include any other sources of financial support that would be used to help offset the total cost of the experience. o See page 4 of application for template Cover Letter from Applicant o Description of the proposed overseas field experience or project in detail, including expected learning objectives, and a statement of how the proposed experience will enrich the applicant s exposure to global health. Students must also briefly describe previous international experience. The letter must include the name and contact information of the International Host Organization (2-page limit). /Letter from host organization (if applicable) o A letter (or email) from the Host Organization outlining the parameters and expectations for the field experience or project, if applicable. Letter from UIC Supervisor o A letter from the applicant s UIC supervisor for the field experience vouching for the applicant s capacity for taking full advantage of this out-of-country field experience and stating her/his willingness to serve as a contact at UIC for the student while out of the country. Project timeline o Please submit a project timeline identifying project activities. Statement about foreign language proficiency o See page 5 of application for questions Copy of UIC transcript o Unofficial transcripts can be obtained by accessing my.uic.edu Completed packet submitted on or before February 26, 2018 APPLICANTS MUST SUBMIT ONE PDF THAT INCLUDES ALL APPLICATION DOCUMENTS Office use only: Date received
3 Applicant Information: Name: Last First UIN# UIC E-Mail Address Alternative Address Telephone UIC School of Public Health Information: Current degree program: MS MPH PhD Academic Division Date matriculated: Semester Year Expected graduation date: Semester Year Academic Advisor: Name Campus Tel. Field Experience Advisor: Name Campus Tel. Host Organization Information: Name of Organization Point of Contact Name Phone Number Location Duration and Dates of Proposed Field Experience: Signatures By my signature below, I authorize release of my name, transcripts and the additional contents of the application with scholarship donors and others in conjunction with any University scholarships I may receive. Applicant Signature: Date Academic Advisor Signature: Date
4 Budget Estimated Travel Budget: Type Estimated Expenses Budget Notes Roundtrip Airfare On-Ground Transportation Housing Meals Emergency Evacuation Insurance (required) https://studyabroad.uic.edu/internationalhealth-insurance/ Travel Visa Vaccinations Translator/ Language Phone/Internet Other Miscellaneous Items Total Please Note: Awards are up to 3,000. If your budget exceeds this amount, please identify how you intend to pay for it.
5 Foreign Language Proficiency What language(s) are spoken in the location of your field experience? What is your proficiency in the language stated above? (Beginner, Intermediate, Advanced)? Will you need a translator during your field experience? (If yes, please build this into your budget on page 3 of the application.) Please indicate below where you intend to obtain a translator. Please describe any language training you will pursue prior to the start of your field experience. Other Comments: