Page 1 of 8 Tribal Early Childhood Research Center Summer Institute Travel and Tuition Scholarship Application AWARD DESCRIPTION The Tribal Early Childhood Research Center (TRC) Summer Institute Scholarship provides financial support for American Indian and Alaska Native (AI/AN) and other scholars, health leaders, health professionals, and paraprofessionals serving AI/AN communities, who are interested in attending the TRC Summer Institute course at the Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health. Course description: The Early Childhood Research with Tribal Communities course is a 2-credit graduate level course. It will: 1) explore research methods and theoretical approaches to understanding early childhood development and intervention strategies in tribal contexts; 2) consider optimal systems of early childhood care in population settings with considerable environmental and structural challenges; and 3) examine unique aspects of tribal research and culture, emphasizing the importance of community-based and community-engaged approaches. Scholarship information: Scholarship awards will cover costs for travel to and from Baltimore, shared hotel accommodations, breakfast and dinner provided by hotel, course materials, and course tuition. Applicants who participated in the TRC Summer Institute 2014 Qualitative and Quantitative Research Methods course, who are seeking an advanced degree or graduate certificate, who work in an tribal early childhood setting and have an interest in research, and who have a significant connection to one or more AI/AN communities are strongly encouraged to apply. Applicants who participated in the TRC Summer Institute 2013 Early Childhood Research with Tribal Communities are not eligible to apply. Applicants with a bachelor s degree who are accepted into the course may take the course for credit; applicants without a bachelor s degree who are accepted into the course may take the course, but will not receive credit. SCHOLARSHIP APPLICATION DEADLINE: Friday, May 1, 2015 by 5:00 pm Eastern Time.
Page 2 of 8 APPLICATION CHECKLIST The completed application package needs to include all of the following (please check each item to indicate it is included or will be sent): Completed and signed application form Most current resume or curriculum vitae Transcripts (official or unofficial) Personal statement (see Section 6 of this application for details) Two recommendations, including a letter and completed recommendation form, with at least one recommendation from a supervisor or faculty advisor detailing your strengths, interests, aspirations, etc., that are less than two years old. Letter and recommendation form must be sent to Nicole Paré directly by the person providing the recommendation. All materials must be received by 5:00 pm Eastern Time, Monday, May 1, 2015 and can be submitted by: Email as a PDF to Nicole Paré at npare1@jhu.edu Or USPS mail to: Nicole Paré Johns Hopkins Center for American Indian Health 415 N. Washington Street, 4 th Floor Baltimore, MD 21231 QUESTIONS? Please contact Nicole Paré at 410-955-6931, or via email at npare1@jhu.edu. Please read the instructions carefully and complete the application in full. Incomplete applications will not be processed. Award notices will be sent to the email address provided in this application.
Page 3 of 8 SECTION 1: PERSONAL INFORMATION Name: Last First MI M/F Date of Birth: Country of Legal Residence: Citizenship: Are you American Indian or Alaska Native? Yes / No Home Address: If yes, what is your tribal background? If yes, are you an enrolled member of a federally-recognized tribe? Yes / No (If yes, please include proof of tribal membership) Street Apt. Suite City State ZIP Work Address: Street Apt. Suite City State ZIP Preferred Mailing Address: Home Work Home Phone: Work Phone: Cell Phone: Email: Fax:
SECTION 2: ACADEMIC SUMMARY (Most recent first) TRC Summer Institute Scholarship Application Form Page 4 of 8 School Area of Concentration Degree/Certification Year Rec d
SECTION 3: PROFESSIONAL SUMMARY (Most recent first) TRC Summer Institute Scholarship Application Form Page 5 of 8 1. Employer Position/Title Responsibilities 2. Employer Position/Title Responsibilities 3. Employer Position/Title Responsibilities SECTION 4: HONORS AND DISTINCTIONS (Most recent first) Description
Page 6 of 8 SECTION 5: EXTRACURRICULAR ACTIVITIES Include school and community activities Description
Page 7 of 8 SECTION 6: PERSONAL STATEMENT Please attach an original essay that: Describes your professional background and interests, particularly as they relate to early childhood programs and working with AI/AN communities. Describe any plans you may have to obtain a degree or certificate. Demonstrates your commitment to future work that supports families and young children in AI/AN communities. Describes how receiving scholarship support to participate in the TRC Summer Institute will assist you in achieving your goals and improving the health and well-being of AI/AN families and young children. Your personal statement is an opportunity to demonstrate your writing skills to our faculty, so take care to submit a concise and well-constructed essay. Statements must: Be current Be between two and three double-spaced pages in length Be dated Have your name on each page We understand that types of background, professional experiences, and academic performance are unique to each applicant and may vary widely from individual to individual. If you feel that our current application does not provide an opportunity for you to share details about your full potential as a promising or continuing leader for the health and well-being of young children and families in tribal communities, please clarify this in this essay. Your essay will be evaluated on: Your personal, professional, and/or academic background particularly as it demonstrates your commitment to improving the health and well-being of young children and families in tribal communities Your academic and/or professional goals particularly as they also demonstrate your commitment to improving health and well-being of young children and families in tribal communities Your potential for future early childhood leadership roles in AI/AN communities A clear vision for how the Introduction to Quantitative and Qualitative Research Methods course will be used to support your goals, particularly related to any plans for an advanced degree or certificate in public health Your overall potential for success in the course
Page 8 of 8 SECTION 7: JHU AFFILIATION Are you currently affiliated with JHU? Yes No If Yes, please indicate how (mark all that apply): Alumnus Employee Attended Continuing Education Courses (i.e. summer or winter Institute courses) in the past Currently a degree-seeking student at JHU If so, please indicate which School: and Degree Program/s: SECTION 8: RECOMMENDATION FORM Two recommendations are required. One of the two recommendations must come from a supervisor or faculty advisor detailing your strengths, interests, aspirations, etc., and another recommendation from either a supervisor or faculty advisor, or someone else in a position who knows your school/career aspirations and can speak to your skillset and motivation. Please forward the separate TRC Summer Institution Scholarship Recommendation form to two people who can recommend you for this opportunity and advise them that the form must be submitted directly to Nicole Pare at the Johns Hopkins School of Public Health, Center for American Indian Health. You may waive the right of access to your recommendation form in order to provide confidentiality to your references. If you wish to waive your right to examine this evaluation, please sign here. Applicant s signature: Date: SECTION 9: AFFIRMATION OF ACCURATE INFORMATION I affirm that the information on this application form, and on any additional materials that I submit related herewith, is complete, accurate, and true to the best of my knowledge. I understand that furnishing any false, misrepresented or incomplete information in any of my application materials may be cause for denial or revocation of scholarship or award, admission, registration or academic credit. I understand that any materials submitted related to my application become the property of the Tribal Early Childhood Research Center and Johns Hopkins University and cannot be returned or forwarded to a third party. I understand that the decision made on my application is final and not subject to appeal. Finally, I agree that if awarded this Scholarship, I will adhere to all the rules and regulations applicable to students of the Johns Hopkins School of Public Health, including but not limited to the Student Conduct Code and Student Honor Code. Please sign here in acknowledgement of the above. Applicant s Signature: Date: