Full Name (First Name, Middle Name, Last Name)

2018 Data Science for Social Good (DSSG)
Fellowship Application Form

Applicant Details:

You must bean undergraduate students who have successfully completed 75 credits, or be graduate students, at UBC at the time of application.International students at UBC are eligible to apply provided you are eligible to work during the summer term (e.g., returning to school in September 2018 or have a work permit).

Full Name (First Name, Middle Name, Last Name):

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Student Number:

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Birth Date (Month, Day, Year):

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Present Address (Street address, City, Province, Postal Code, Country):

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Permanent Address (Street address, City, Province, Postal Code, Country):

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Telephone Number:

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E-mail:

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Citizenship:

☐Canadian ☐ Permanent Resident ☐ International Student

If you are an International Student, please indicate when your student/work visa expires:

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Education:

Please give details of all Schools/Colleges/Universities attended.

Current educational level:Choose an item.

Undergraduate Education:

Institution / GPA / Department / Highest Degree Obtained / Dates Attended (mm/yy) – (mm/yy)
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Graduate Education:

Relevant Experience:

We expect DSSG Fellows to have some analytical/technical experience as well as to have demonstrated an interest in working on projects relevant to social good (through research projects, paid and/or volunteer work, etc.). Please make sure to include relevant activities below.

Please list any relevant research, work, or volunteer experience (e.g. technical, social good):

Organization / Position / Summary of responsibilities / Links to relevant projects or code
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Please check the boxes for the language(s) with which you can execute the tasks listed (check all that apply):

Python / R / Matlab / Julia / SQL / Java / C/C++ / Stata/
SAS / Shell scripting (e.g., bash) / Other
Never heard of this language / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
Heard of this language but never used / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
Print “Hello World!” to console / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
Write any function / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
Read data from tab-delimited file / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
Import a library or package / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
Produce a plot or graph / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
Train statistical or machine learning model / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
Work with > 1TB of data / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /
Develop a complex application or module / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ /

If you chose "Other", please list the programming languages you have experience with:

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Link(s) to your GitHub account, or online code, if available:

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Briefly describe any experience with human-centered design or user experience. (100 word limit):

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Briefly describe any experience working in teams or on collaborative research. (100 word limit):

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Describe the most challenging project that you have worked on and why it was challenging. (100 word limit):

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Describe your favorite project that you have worked on. (100 word limit):

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Personal Statement:

We want to understand what you hope to get out of the DSSG program and what assets you would provide to your student team and project.

What are your expectations for the DSSG program? What do you hope to learn?(100 word limit):

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What skills will you bring to the DSSG program? (100 word limit):

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Is there anything you would like us to know about you that is not covered by the previous questions? (100 word limit):

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Supporting Documents:

Please includea copy of your CV and unofficial copies of your transcripts (in PDF format) when you submit this form.

Reference:

All applicants must provide at least one reference. Letters are *not* being requested at this time.

Name of referee / Organization / Relationship / Contact Information
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Declaration

By completing this form, I certify that, to the best of my belief, the information I have provided is complete and true.

(Type:First Name, Last Name):

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(Date: day, month, year)

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Email completed form, copy of your CV and unofficial transcripts to .

The University of British Columbia respects and supports the protection of your privacy. The personal information you provide through this application form is collected pursuant to section 26 of the BC Freedom of Information and Protection of Privacy Act (FIPPA), RSBC 1996, c.165. The personal information is collected for recruitment purposes and other related UBC purposes that may include the following:

Providing information and advice on your course and program needs
Informing you of upcoming recruitment events
Providing ongoing service and assistance to understand your post-secondary educational needs
Statistical purposes

Your personal information will only be accessible by authorized UBC employees and representatives, or as otherwise permitted by law. UBC will not disclose your personal information to an outside third party unless permitted by law.

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