Josie R. Johnson UROC Engaged Dissertation Fellows ProgramApplication Packet

Application Process

Confirm that you are eligible. Obtain names/contact information and submit two letters of recommendation – one from

community partner and one from a faculty advisor. Complete application packet and submit along with a CV to Dr. Lauren Martin. Application packet should be submitted as a single doc or pdf file via e-mail with the subject

headline – Application for the Josie R. Johnson UROC Engaged Dissertation Fellows Program to:

Lauren Martin, PhDDirector of ResearchRobert J. Jones Urban Research and Outreach-Engagement Center (UROC)2001 Plymouth Avenue North Minneapolis, MN 55411612-624-0435mart2114@umn.edu

DEADLINE TO APPLY: 11:59PM, NOVEMBER 16TH, 2018

Application Checklist

Application Form and CV

A dissertation abstract (1-2 pages)

A list of professional development goals related to community-engaged scholarship

A list of committee members with a signature from advisor or committee chair; and

Two letters of recommendation (one from community partner and one from faculty)

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Josie R. Johnson UROC Engaged Dissertation Fellows ProgramApplication Form

1. Applicant’s Full Name: _______________________________________________

2. Street Address: _____________________________________________________ 

City: ______________________________________________________________

State: _____________________________________________________________

Zip: _______________________________________________________________

3. Telephone: ________________________________________________________

4. Email: _____________________________________________________________

5. Please provide the following information:

Doctoral Program ___________________________________________________

Program Division/School ______________________________________________

Year in Program _____________________________________________________

Research/Faculty Advisor _____________________________________________

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A. Provide a brief abstract of your dissertation. (Limit ~ 1-2 pages)

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B. What are your professional development goals and how do you see this community-engaged fellows program contributing to these goals? (Limit ~ 300 words)

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6. Committee Member Information and Signature of Approval:

Name of Committee Member #1: ____________________________________________

Name of Committee Member #2: ____________________________________________

Name of Committee Member #3: ____________________________________________

Name of Advisor/Committee Chair: __________________________________________

Signature of Advisor/Committee Chair: _______________________________________

7. References/Recommendations: In evaluating your candidacy, we request that you identify, request, and submit two letters of recommendations from your community partner and a faculty member who is acquainted with your academic experience and research work.

Please list names and contact information (phone and email) for your two references:

1. Community Partner/Organization: ______________________________________

a. Organizational Contact Person: ___________________________________

b. Organizational Contact Information (phone and e-mail): ________________

_____________________________________________________________

2. Faculty Member: _____________________________________________________

a. Faculty Contact Information (phone and e-mail): _______________________

______________________________________________________________

8. How did you hear about the Josie R. Johnson UROC Engaged Dissertation Fellows

Program? _________________________________________________________________

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