Stanford-NBC News Fellowship in Media and Global Health
Application for 2015-2016 Academic Year
Instructions
Please type in the shaded areas. All documents must be received (via e-mail or post) by 3 pm PST, Tuesday, February 17, 2015. This fellowship begins in June 2015.
You will need the following:
· this completed application;
· letter of interest which includes your career goals within the field of global health and how this fellowship will be helpful to you;
· two letters of recommendation preferably from supervisors of global health activities;
· current CV.
Please email or mail all application materials in one packet (with exception of letters of recommendation which should be emailed separately) to:
Andrea Sprockett, Director of Educational Programs in Global Health
Stanford University
Stanford University Center for Innovation in Global Health
1265 Welch Road, X3C42
Stanford, CA 94305
Email Address:
Personal Information
Name
Address
City, State, Zip
Home Telephone
Country of Citizenship
Email Address
Background/Experience
Institution:
Affiliation: Medical Student Resident Faculty
Current Year: Med Student Year 2 Med Student Year 3 Med Student Year 4
Intern PGY-2 PGY-3 PGY-4 Other:
If you are a resident, please specify specialty: Medicine Pediatrics Surgery Ophthalmology
OB/GYN Emergency Medicine Other
Languages:
Spoken Proficiency Level*:
Elementary proficiency Limited working proficiency Minimum professional proficiency
Full professional proficiency Native or bilingual proficiency
Reading Level*:
Elementary proficiency Limited working proficiency Minimum professional proficiency
Full professional proficiency Native or bilingual proficiency
Writing Level*:
Elementary proficiency Limited working proficiency Minimum professional proficiency
Full professional proficiency Native or bilingual proficiency
*Learn more about language proficiency levels here.
Have you had prior experience working in health care settings outside of the US? Yes No
If yes, provide locations, dates, sponsoring organization, and describe briefly your experience?
What do you hope to gain through this fellowship and where you see yourself in five years?
Of types of media listed below, please rank which is most interesting to you from 1 to 5.
(1 is most interested and 5 is least interested)
Photography
Radio
Social Networking
Television
skills rating
How would you rate yourself in the following areas from 1 – 10 (1 is a beginner and 10 is advanced):
1. Word Processing
2. Spreadsheets
3. Web Publishing
4. Email
5. Presentation
6. Database
7. Photo Editing
Year-Long Project
As part of this fellowship, fellow will be mentored toward the goal of producing a publication in a global health topic of choice. List three topics that you might want to investigate in-depth during the fellowship and your reasons for choosing these topics.
1.
2.
3.
Deadline to apply
February 5, 2014