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Community Engagement and Outreach Core Summer Institute Application Form

Name Of Applicant *

Degree(s) *

Academic Rank/Title *

University *

Department *

Position *

Phone *

Email *

Academic Discipline *

Please attach the following documents as part of your application:

Your curriculum vitae *

A 2-3 page application letter of interest. Describe your research interests, and include a description of any research activity that is not reflected in your CV. Indicate why you are interested in attending the Community-Engaged Research Summer Institute and how you see if fitting in with your research and professional goals. Please name your file “YourLastName,YourFirstName.ApplicationLetter:” *

A letter of recommendation from your department chair or a senior faculty member who is familiar with your professional capabilities, experience, and research potential in community-engaged research. *