2017 Doctoral Application Support Award (DASA)

Award Overview

The purpose of the Minority Training Program in Cancer Control Research (MTPCCR) is to increase ethnic diversity in the field of cancer disparities research by raising the awareness of minority master’s students and master’s level health professionals in public health and social/behavioral sciences to the opportunities in research and motivating them to pursue a doctorate. The MTPCCR is a joint program of the University of California, San Francisco (UCSF) Helen Diller Family Comprehensive Cancer Center and the University of California, Los Angeles (UCLA) Fielding School of Public Health, with support from the National Cancer Institute and is comprised of three components: (1) a 5-day summer institute at each of the program universities, (2) paid internships on cancer disparities research studies, and (3) doctoral application support awards.

The Doctoral Application Support Award (DASA) was established to address a significant barrier to apply for doctoral programs: the financial costs associated with the doctoral application process, and potential visits to the campuses of choice.

Funding Available

Each year, Summer Institute alumni who are interested in pursuing a doctorate in a field that could lead to a career in cancer disparities research will be selected to receive the award. Each awardee will receive up to $2,000 to cover the costs of doctoral program applications, testing, and/or campus visits. Please note that we are only able to reimburse costs after they have been incurred. Your application must include an itemized budget accompanied by original receipts for each item.

Eligibility

Participants must be:

§  MTPCCR Summer Institute alumni (from any program year).

§  Committed to apply to a health science doctoral program that could lead to a career in cancer disparities research.

§  Provide a short paragraph describing your financial need.

Timeline

§  Deadline: Friday, December 8, 2017 at 5:00pm (PST)

§  Completed applications must be EMAILED* to the program site you attended.

§  Application review process begins mid-December.

§  Applicants notified by January 31, 2018.

Application and Checklist

Before submitting, please verify that all materials on the checklist are included in your application packet, and ensure that your name appears on all documents submitted. An application will not be evaluated or reviewed unless all application materials are received by the deadline. * Faxed/mailed applications are not accepted.

Completed MTPCCR Doctoral Application Support Award (DASA) Application.

Award proposal.

Itemized receipts for each expense.

Copy of completed application form for each doctoral program that applicant is applying to. At least one completed doctoral program application must be included to be considered for the DASA.

Please Note: You DO NOT need to include a copy of the full application packet (personal statement, transcripts, LORs, test scores, etc.) for each school. What we are requesting is confirmation that the full application was submitted. This can be a copy of the submission confirmation page or a “receipt of application” confirmation email.

Doctoral Application Support Award (DASA) Application

A.  Personal Information

Last Name: / First Name: / Middle Initial:
Address:
City: / State: / Zip Code:
Email address:
Cell Phone: / Home/Evening Phone:
Year attended MTPCCR Summer Institute:

B.  Education

School:
Graduate program: / Degree/s completed:
Graduation Date (MM/YYYY): / Current/Final GPA:
Address:
City: / State: / Zip Code:
Faculty Advisor: / Phone Number:

C.  Financial Information

i. Employment

Are you currently employed? Yes No

If yes, please provide the following information:

Employer Name:
Address:
City: / State: / Zip Code:
Phone Number:
Number of hours worked per week: / Salary per month: $

ii. Student Loans

Did you receive financial aid while attending a master’s program? Yes No

If yes, please list below each type of aid you received

Type / Amount / Date (MM/YYYY)
$
$
$
$
$
$
Amount Currently Outstanding / $

D.  Signature of Applicant

By signing below, I certify that I am eligible to apply for the MTPCCR Doctoral Application Support Award. To the best of my knowledge, the information that I have provided in this application is complete and accurate.

Name (type or print) / Signature / Date

E.  Award Proposal

Please address the items listed below on the following pages:

I.  PURPOSE: State the reasons you are pursuing a doctorate in a field that could lead to cancer research (1 paragraph).

II.  FINANCIAL NEED: Clearly explain your financial need (1 paragraph).

III.  DOCTORAL PROGRAMS: List all of the doctoral programs, institutions, and locations you are applying to. Please attach the completed application form for each doctoral program (At least one completed doctoral program application must be included to be considered for the DASA). If you are applying to a school of Public Health and using SOPHAS for your application, please note all the school to which you applied and number of applications over the number of applications covered by the basic fee.

IV.  BUDGET: Provide a budget justification for costs and resource needs related to applying and selecting a doctoral program. Include costs related to application fees, GRE preparation, GRE testing, travel to campus sites (local, state, or out-of-state), and other relevant expenses. Maximum amount of award is $2,000. PLEASE NOTE that each individual site administering the GRE may award reduced fees if you qualify as a low-income applicant. Please make sure to ask.

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AWARD PROPOSAL

I. PURPOSE

II.  FINANCIAL NEED

III.  DOCTORAL PROGRAMS*

School / Program / Location (City, State)

*Please include a copy of your completed doctoral application. At least one completed doctoral program application must be included to be considered for the DASA.

IV.  BUDGET

Description / Amount
Application fees / $
GRE preparation & testing / $
Travel to campus sites / $
Other expenses / $
Total Requested / $

Justification:

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