Josie R. Johnson UROC Engaged Dissertation Fellows ProgramApplication Packet
Application Process
Confirm that you are eligible. Obtain names/contact information and submit two letters of recommendation – one from
community partner and one from a faculty advisor. Complete application packet and submit along with a CV to Dr. Lauren Martin. Application packet should be submitted as a single doc or pdf file via e-mail with the subject
headline – Application for the Josie R. Johnson UROC Engaged Dissertation Fellows Program to:
Lauren Martin, PhDDirector of ResearchRobert J. Jones Urban Research and Outreach-Engagement Center (UROC)2001 Plymouth Avenue North Minneapolis, MN [email protected]
DEADLINE TO APPLY: 11:59PM, NOVEMBER 16TH, 2018
Application Checklist
Application Form and CV
A dissertation abstract (1-2 pages)
A list of professional development goals related to community-engaged scholarship
A list of committee members with a signature from advisor or committee chair; and
Two letters of recommendation (one from community partner and one from faculty)
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Josie R. Johnson UROC Engaged Dissertation Fellows ProgramApplication Form
1. Applicant’s Full Name: _______________________________________________
2. Street Address: _____________________________________________________
City: ______________________________________________________________
State: _____________________________________________________________
Zip: _______________________________________________________________
3. Telephone: ________________________________________________________
4. Email: _____________________________________________________________
5. Please provide the following information:
Doctoral Program ___________________________________________________
Program Division/School ______________________________________________
Year in Program _____________________________________________________
Research/Faculty Advisor _____________________________________________
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A. Provide a brief abstract of your dissertation. (Limit ~ 1-2 pages)
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B. What are your professional development goals and how do you see this community-engaged fellows program contributing to these goals? (Limit ~ 300 words)
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6. Committee Member Information and Signature of Approval:
Name of Committee Member #1: ____________________________________________
Name of Committee Member #2: ____________________________________________
Name of Committee Member #3: ____________________________________________
Name of Advisor/Committee Chair: __________________________________________
Signature of Advisor/Committee Chair: _______________________________________
7. References/Recommendations: In evaluating your candidacy, we request that you identify, request, and submit two letters of recommendations from your community partner and a faculty member who is acquainted with your academic experience and research work.
Please list names and contact information (phone and email) for your two references:
1. Community Partner/Organization: ______________________________________
a. Organizational Contact Person: ___________________________________
b. Organizational Contact Information (phone and e-mail): ________________
_____________________________________________________________
2. Faculty Member: _____________________________________________________
a. Faculty Contact Information (phone and e-mail): _______________________
______________________________________________________________
8. How did you hear about the Josie R. Johnson UROC Engaged Dissertation Fellows
Program? _________________________________________________________________
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