optiMize Summer Fellowship Application 2019
Each individual in the Social Innovation Challenge intending to apply for funding must complete this form before Sunday, 2/17/18 at 11:59PM
Email address *
First Name *
Last Name *
Team Name *
UMID *
Graduation Year *
College *
Do you qualify for need-based financial aid? (This information will be held confidential and has no impact on our funding decisions, but is important to how we initiate funding transfers.) *
Are you currently or have you ever been employed by the University of Michigan? (check yes if you have any temporary or part-time roles, including as research assistant)
Please upload a headshot photo of yourself! *
Required
Personal References
Please list name, phone number, and email for 2 individual references. Please ask for permission from these two people before you send us their contact information. We may reach out to them for a conversation after your team's final pitch.
Reference #1 Full name, email, phone *
Reference #2 Full name, email, phone *
Fellowship Program Specifics
Note: If you commit to work on your project this summer, your team has a stronger chance at receiving a Project Grant
Is working on this project your first priority for the summer? *
Can you commit to working 40 hours per week on your project? *
If you answered 'No' to the previous question, please elaborate on how many hours you can commit to your project per week, and explain why this is the case.
Where do you plan to work over the summer? *
If you won't be in Ann Arbor over the summer, can you tell us where you'll be and why? (If you're in Ann Arbor, answer "N/A") *
If you receive an optiMize fellowship, do you plan to pursue another job, internship, or research position on campus or elsewhere? *
If you answered 'Yes' to the above question, please elaborate. (NOTE: This does NOT disqualify you for fellowship funding! We want to know your plans so that we can better understand your situation before the selection committee make funding decisions) *
Do you plan to take classes during the spring and/or summer term?
Are you a student athlete on a scholarship?
Can you commit to attending one 3-hour evening meeting each week with the cohort of Fellows? *
Can you commit to attending a weekly 1-on-1 meeting with optiMize Staff? *
I acknowledge my responsibility to proactively communicate any changes to my schedule and summer plans with optiMize leaders *
I plan to be in Ann Arbor during the following weeks: (NOTE: If you will be absent from fellowship meetings for more than two weeks you will need to reach out to optiMize staff to come up with a special working arrangement. Up to two weeks of vacation is allowed, but more than that and we will need to discuss proration of your fellowship stipend) *
Yes
No
May 12-18
May 19-25
May 26-June 1
June 2-8
June 9-15
June 16-22
June 23-29
June 30-July 6
July 7-13
July 14-20
July 21-27
July 28-August 3
August 4-10
August 11-17
Reflecting on the Social Innovation Challenge
Answer the following questions in no more than 200 words each
How engaged have you been in the optiMize Challenge and community? *
How have you supported other optiMizers? *
Have you actively responded to feedback you’ve gotten? *
Looking Forward
Answer the remaining questions in no more than 200 words each
Why do you want to be an optiMize Fellow? *
What do you bring to the optiMize community? *
How could we best support you this summer? *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of University of Michigan. - Terms of Service