Univ Michigan PH_1

8/3/2019 Univ Michigan PH_1

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PROGRAM:

BENEFITS:

CONTACT:

APPLY:

A 10-week residential program aUMSPH to expose undergraduaand recent graduates to publichealth.

Program runs from May 27 to

August 3, 2012.

8-week internship in a publichealth setting

Group learning at the UMSPHCDC

Stipend & housing Round trip transportation from

your home to Ann Arbor, MI GRE preparatory course

FPHLP Project Coordinator,Charlita Daniels [email protected]

http://sitemaker.umich.edu/um-fp

Increasing diversity in the public health workforce

UMFPHLP is funded through a cooperative agreement with the Centers for Disease Control and Prevention(CDC), Office of Minority Health and Health Equity (OMHHE)
mailto:[email protected]://sitemaker.umich.edu/um-fphlphttp://sitemaker.umich.edu/um-fphlphttp://sitemaker.umich.edu/um-fphlphttp://sitemaker.umich.edu/um-fphlpmailto:[email protected]


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University of Michigan School of Public Health

Future Public Health Leaders Program

University of Michigan Future Public Health Leaders Program (FPHLP)

Instructions: Please type or print in blue or black ink. Please read carefully and complete all sections of

the application. Application Deadline: February 10, 2012

Identifying Information

Last name: ________________________First: _________________________Middle:________________

Date of Birth: ______/_______/________ Sex: Female: ____ Male: ____

Current Mailing Address: (I will be at this current address until: _______/_________/________)

Street: ________________________________________________________________________

City: __________________________________ State: _________ Zip Code: _________________

Current Phone: ( ) ________-_________ Email: _____________________________________

Permanent Mailing Address: (Where you can be reached after June 1, 2012)

Street: ________________________________________________________________________

City:__________________________________ State: _________ Zip Code:__________________

Permanent Phone: ( ) ______- ___________

Which of the following races/ethnicities do you consider yourself? (Check all that apply)

African-American Asian-American Hispanic/Latino Alaskan Native/ American Indian

Native Hawaiian/Pacific Islander Other_________________(Describe)

Citizenship: Applicants must be a US citizen, US National or permanent resident to participate in the program

(check one)

US Citizen Permanent Resident US National


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Please indicate which area you are most interested:

Health Behavior Health Education (HBHE) Health Behavior Health Education (HBHE) is concerned with

the factors associated with health-related behavior and health status, and develops and evaluates

innovative strategies to address and improve individual and community health.

Environmental Health Sciences (EHS) are concerned with the impact of environmental conditions on

human health -- in particular the health effects in people that can arise from exposures to agents

(chemical, biological, physical, or even behavior) through the air they breathe, the water they drink, the

food they eat, and the manner in which they go about their lives and their work. Environmental health is a

multidisciplinary field grounded in the physical life sciences with applications to the social, management

and political sciences.

How did you hear about our program?

Career Services Professor/Advisor Website/Listserv Friend

Conference/Recruitment Event, please list:_____________________________

Other, please indicate:__________________________

Are you:

A first generation college student: YES NO From a family considered low income using the Federal Poverty Guidelines

(Please see:http://aspe.hhs.gov/poverty/11poverty.shtml)

) YES NO
http://aspe.hhs.gov/poverty/11poverty.shtmlhttp://aspe.hhs.gov/poverty/11poverty.shtmlhttp://aspe.hhs.gov/poverty/11poverty.shtmlhttp://aspe.hhs.gov/poverty/11poverty.shtml


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Education

In September of 2012, I will be (circle one): Junior Senior Recent Graduate (2011/2012)

What is your major? ____________________________ Cumulative GPA: ______/4.0

Total Credit Hours completed by May 2012 _____________

List the most recent college(s) or universities that you have attended:

Current Institution: ________________________________________________

City ____________________________ State _____________________

Second College /University: ________________________________________________

City ____________________________ State _____________________

Extracurricular Activities: List any community service activities (student or community organizations,

health programs, clubs, etc.).

Have you ever participated in a summer academic enrichment program or summer research program?

No

If yes, please list the name(s) of the program, the location and the dates attended:


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References:

Two (2) letters of recommendation are REQUIRED. The letter should be mailed directly to us from each person

writing the recommendation. Note: At least one letter should be written by a professor/ academic instructor whohas taught you, and the other can be written by an advisor, counselor, or employer.

List names and titles of the people you have asked to complete the 2 recommendation forms you received with

your application.

Name _____________________________________________________________________________

Title ______________________________________________________________________________

Institution _________________________________________________________________________

E-mail Address______________________________________________________________________

Date requested _________________________________

Name _____________________________________________________________________________

Title ______________________________________________________________________________

Institution _________________________________________________________________________

E-mail Address______________________________________________________________________

Date requested _________________________________

I certify that the above information is true, complete and correct to the best of my knowledge. I

understand that falsifying or providing incorrect information may jeopardize my participation in this

program, or future University of Michigan School of Public Health programs.

Student Signature: ______________________________________________________________

Date _________________________________________


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ESSAY

Provide a typed essay in which you address the following:

The overall goal of the FPHLP is to expose participants to the field of public health and to explore educational

and employment opportunities focusing on advancing population health, improving our environment, and

eliminating health inequalities. Please explain how your education, life experience, and short and long term

goals would be applicable to a career in public health.

Specifications: The essay must be typed, double-spaced using 12-point Times New Roman font. There is

a 1500 word maximum.

Attach your typed essay to the application, and include your name on each page of your essay.

The complete application packet should include:

A legible application form with all sections filled out. Officialcollege transcripts from each institution you have attended in a sealed

envelope.

The required essay A current resume

Please mail all application materials and transcripts together in a large manila

envelope to the following:

ATTN: Charlita Daniels



1415 Washington Heights

Ann Arbor, MI 48109

Application packets must be postmarked by February 10, 2012


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CONFIDENTIALApplicant Recommendation Form

The University of Michigans School of Public Health hosts a ten-week summer program, the Future Public Health

Leaders Program (FPHLP), which is designed to expose participants to public health careers and to the racial, ethnic

and socio-economic inequalities that exist in the US. The goal of the program is to encourage the student to

consider the field of Public Health as a career option. Your candid and thoughtful evaluation of the applicant is

greatly appreciated. Please attach a letter written on official letterhead to this form. In your letter, please describe

the students qualities, characteristics and if known, potential as a health care professional. Also, include any

known academic weakness (test-taking, study skills, writing, etc.) to assist us in working with the students during

the program.

Please return this completed form and attached letter of recommendation to the address below. Letters should

be postmarked no later than February 10, 2012.

Student Name: ________________________________________________________

Characteristics Excellent Very Good Fair Poor No Basis to Judge

Interpersonal Skills

Maturity & Judgment

Dependability & Reliability

Perseverance

Character & Integrity

Initiative

Leadership

Ability to Adapt to New

Situations

Name _____________________________ College/Dept ______________________________

Position/Title _________________________ Signature_____________________ ____________

PLEASE SEND TO: Charlita Daniels, Summer Programs Manager


1415 Washington Heights Ann Arbor, MI 48109


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CONFIDENTIALApplicant Recommendation Form

The University of Michigans School of Public Health hosts a ten-week summer program, the Future Public Health

Leaders Program (FPHLP), which is designed to expose participants to public health careers and to the racial, ethnic

and socio-economic inequalities that exist in the US. The goal of the program is to encourage the student to

consider the field of Public Health as a career option. Your candid and thoughtful evaluation of the applicant is

greatly appreciated. Please attach a letter written on official letterhead to this form. In your letter, please describe

the students qualities, characteristics and if known, potential as a health care professional. Also, include any

known academic weakness (test-taking, study skills, writing, etc.) to assist us in working with the students during

the program.

Please return this completed form and attached letter of recommendation to the address below. Letters should

be postmarked no later than February 10, 2012.

Student Name: ________________________________________________________

Characteristics Excellent Very Good Fair Poor No Basis to Judge

Interpersonal Skills

Maturity & Judgment

Dependability & Reliability

Perseverance

Character & Integrity

Initiative

Leadership

Ability to Adapt to New

Situations

Name _____________________________ College/Dept ______________________________

Position/Title _________________________ Signature_____________________ ____________

PLEASE SEND TO: Charlita Daniels, Summer Programs Manager


1415 Washington Heights Ann Arbor, MI 48109

Documents

Univ Michigan PH_1