2017 Community-Based Research Fellowship Common Application

Application Deadline: February 27 at 11:59pm. Be sure to have your faculty mentor complete the mentoring plan found at: http://web.stanford.edu/~churd/CBRfacmentoringplan.fb

* indicates required fields.

Haas CBR Fellowship Information

For more information on the Haas Community-Based Research Fellowship, visit: https://haas.stanford.edu/students/community-based-research-students/community-based-research-fellows-program.

CSRE CBR Fellowship Information

For more information on the Comparative Studies in Race and Ethnicity Community-Based Research Fellowships, visit: http://csrecbr.weebly.com/

I AM APPLYING FOR (check all that apply) *

1. APPLICANT INFORMATION


Name *











2. PROJECT BUDGET



3. ACADEMIC LEARNING GOALS




4. For Haas Center CBR Fellowship and CSRE Student-Initiated Projects ONLY

(SKIP to Section 5 if applying only for the CSRE Community-Initiated Fellowship)

COMMUNITY PARTNER INFORMATION. All fields required.





Contact Person's Work Address







RESEARCH GOALS (SKIP this section if applying only for the CSRE Community-Initiated Fellowship)




5. For CSRE Community-Initiated Projects ONLY

Visit crsi.weebly.com for project descriptions. (SKIP to Section 6 if applying only for the Haas Center CBR Fellowship or CSRE Student-Initiated Project Fellowship)





6. REQUIRED FOR ALL APPLICANTS


By checking the box below, I certify that all information is true and accurate to the best of my knowledge. I also understand and agree to release personal information to the fellowship administrator and the selection committee for the sole purpose of selection and award. *