Randall Lewis Fellowship Application Form

Instructions:
Submit documents for sections 1-5 (described below) in the required upload fields and fill out the form below. For section 6- provide 2 recommenders’ full names and email addresses. Your application will include the following:

1. Online form
2. A cover letter
3. Your purpose statement
4. Your most recent résumé
5. A copy of your most recent university transcript (Your name must be visible on the copy provided)
6. Provide names and email addresses of your recommenders. -Please contact your recommenders before submitting their information. Please have them send their letters of recommendation to jaynieboren@hc2strategies.com.  Applications are not considered complete without your letters of recommendation.

 

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Randall Lewis Fellowship Application Form

  • Accepted file types: pdf.
  • Accepted file types: pdf.
  • Drop files here or
    Accepted file types: pdf.
  • Please provide the full names and email addresses of two (2) recommenders for your application. One letter of recommendation should be academic (obtained from individuals who can speak to your academic qualifications e.g. professors or academic advisors) and the other professional or personal (e.g. a current or former employer or volunteer supervisor, pastor, or community leader). Please notify recommenders in advance about your pending application for the fellowship.
  • Date Format: MM slash DD slash YYYY
  • Section Break

  • A synopsis of your community involvement, including past and current extracurricular and volunteer activities in the community and on campus (1 page or less.)
  • Your statement of interest should detail your motivation for a career in health influencing policy, a description of what you hope to gain from the Fellowship, and how your experiences and education will complement the Randall Lewis Health Policy Fellowship (500 words max). Please include in your statement of interest or community involvement synopsis at least one example of cultural competency AND your interest or experience working in Southern California communities.
  • Section Break

    On average how difficult was it for your family to meet expenses for basic needs like food, clothing, and housing?
    On average how difficult was it for your family to meet expenses for basic needs like food, clothing, and housing?
    On average how difficult was it for your family to meet expenses for basic needs like food, clothing, and housing?
  • Please provide Name (First, Last) and today’s date to acknowledge your signature of this form.
  • Date Format: MM slash DD slash YYYY
  • *Please make sure Javascript is enabled. Supported browsers include Chrome 47+, IE 10+, and Firfox 45+
  • This field is for validation purposes and should be left unchanged.