IntraHealth Summer Fellows Program

Summer2016 Application

Sponsored by IntraHealth and administered by the Gillings Global GatewayTM, UNC Gillings School of Global Public Health

IntraHealth is a North Carolina-based non-profit organization that has served the public health needs of developing countries for more than 35 years. IntraHealth's mission is to empower health workers to better serve communities in need around the world. We foster local solutions to health care challenges by improving health worker performance, strengthening health systems, harnessing technology, and leveraging partnerships.(
The Gillings Global GatewayTMat the UNC Gillings School of Global Public Health is the organizing unit for global health activities at the School. Program Coordinator, Naya Villarreal,is the contact for the Fellows Program. The Gillings Global Gateway coordinates interdisciplinary global health research, teaching, and practice across all departments and programs in the School. Our goals include: Increase the School's funding opportunities for global health-oriented teaching, research and practice; Enhance cooperative partnerships with individuals and institutions across UNC, North Carolina, the U.S., and other countries around the world; Increase the emphasis on global health issues in curricula in the School and its departments; Update and maintain information, education, and communication resources about global health activities in the School of Public Health; Provide a visible focal point for global health activities within the School. ( )

Application materials due January 21,2016

Please complete this application, then sign and date your “Applicant Certificationand Acceptance” statement.Submit application
materials electronically to .For hard copies of transcripts, please mail directly to:Gillings
Global Gateway, CB#7400, 104 Rosenau, UNC Gillings School of Global Public Health, Chapel Hill, NC 27599-7400.
Attach the following as a supplementto this application:
  • Resume or CV
  • Three Recommendations: At leastone from afaculty member (current or past)andone from former employer or professional recommendation.
  • Current unofficial transcript (hardcopy, no e-mails).
Summer Fellows Program support for each student: $3,000 from IntraHealth.
Personal
Last Name First Middle / Daytime/Evening Phone Number
Street Address / Email Address
City, State, Zip Code
Citizenship Status (check one) U.S. Permanent Resident Student Visa; Type
Proof of your identity and eligibility will be required.
LANGUAGE PROFICIENCY(Please Mark “X” in boxes that apply)

Language

/

Speaking

/

Reading

/

Writing

/

Comprehension

Fair / Good / Exc. / Fair / Good / Exc. / Fair / Good / Exc. / Fair / Good / Exc.

GENERAL EDUCATION

Level

/ Name and Location of School / Degree Program and Department / No. Years Completed / Did you Graduate? / Degree/Diploma
(Year received/anticipated)
High School
Undergraduate
Graduate
Graduate
Other

INTRAHEALTHSUMMER FELLOWSAPPLICANTS – Please rank your top five areas of interest below (1 highest--5 low).

Complete the final questions of this application, then sign and date your “Applicant Certificationand Acceptance” statement (since you are

submitting electronically, type your name onto the signature line).

____Human Resources Management_____Health Policy and Advocacy____Reproductive Health/Family Planning

____Education and Performance_____Community Engagement____ Maternal and Child Health

____ Leadership and Governance_____Digital Health____ HIV/AIDS and Infectious Disease

____ Measurement and Analytics_____Private Sector Engagement ____Gender Equality

How do you see the Summer Fellows Program at IntraHealthfitting in with your career plans? Please limit your answer to 200 words or less.
Summarize the background (e.g. experience, skills, education, research or programmatic--domestic and international) you feel
would be useful to you as an IntraHealth Fellow. Please limit your answer to 100 words or less.
What types of research topics are you interested in pursuing for a dissertation or master’s paper? Please limit your answer to 100 words or less.
List all prior funding or scholarships obtained for research and practice (include award dates and institution).

aPPLICANT CERTIFICATION AND ACCEPTANCE: I hereby certify that there are no willful misrepresentations, omissions, or falsifications in the statements and

answers on this application. I am aware that the Gillings Global Gateway and IntraHealth International’sconsideration of this application may include an investigation

regarding any and all statements and answers made,and I hereby consent to such investigation. I am aware that should an investigation disclose any misrepresentation,

omissions, or falsification, my application will be rejected.

Signature: ______Date: ______

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November 2, 2015