W.T. Gill Summer Fellowship

Student Application

Students use this form to apply for Gill fellowships. Students may apply for funding for a project that was submitted by a faculty member, or they may work with additional GW or CNHS faculty to create a new project. Before the student can apply for funding using this form, they must have faculty approval on letterhead to work on the project.

Please see the Program Description and Selection Criteria for more information.

* 1. Applicant's information

* Name:
 
* Address:
 
Apt/Suite:
 
* City:
 
* State:
 
* Zipcode:
 
* Cell Phone:
 
* Email Address:
 
* Graduating Class:
 
*Are you a member of the Scholarly Concentration Program?
 
If yes, please list the Track area:

* 2. Faculty Sponsor

* Name:
 
* Degrees:
* Title:
 
* Organization:
 
* Address:
 
Apt/Suite:
 
* City:
 
* State:
 
* Zipcode:
 
* Office Phone:
 
* Email Address:
 

3. Daily Supervisor (optional)

Name:
 
Degrees:
Title:
 
Organization:
 
Address:
 
Apt/Suite:
 
City:
 
State:
 
Zipcode:
 
Office Phone:
 
Email Address:
 

Project Description

* 4. Project title (250 characters limit)


(Maximum characters: 250)
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* 5. Project overview must have clearly defined goals and measureable objectives (e.g. number of patient records, assays completed). Indicate the main question being tested (500 word limit)


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* 6. Hypotheses (150 word limit)


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* 7. Project structure: (500 word limit) Please describe time frame, breakdown of activities, and student role in the project.

Selection criteria include:

  • The project design makes it likely that the objectives will be achieved
  • The project is likely to result in a report of interest to other scholars
  • The project fulfills discovery/original research

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*8. Does this project have IRB approval? Please note: Students cannot begin a human subjects project without IRB approval.

* (Please select ONE)

Yes
No (Pending)
No (Not required)

Educational Value

* 1) Explain the impact your project will have on the healthcare community (200 word limit)


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* 2) Explain how you will use this project to further your educational and career goals (200 word limit)


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Mentor Support

* 1) Describe your mentor's research (250 word limit)


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* 2) Citations of up to three publications by the mentor (within the last three years). The mentor team must be productive and provide a strong scholarly environment. Projects without recent publications are unlikely to be filled.

* 3) Describe the role that your mentor will play in helping you achieve your objectives for this project (250 word limit)

Please include:

  • How the project utilizes support/infrastructure from the mentor/host site.
  • The location and facilities for the research project

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* 9. Personal Statement: Please explain your interest in the project and past experience related to the project. (500 word limit)


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10. Applicant's CV

*Please upload applicant CV.
 

11. Letter of acceptance from the on-site mentor. This confirmation must be provided on letterhead and must include specific information regarding the project, supervision structure, and the student's responsibilities.

*Please upload letter of acceptance.
 
 
 

Funding and Support