Center for International and Professional Experience
CIPE Yale College Summer Fellowships
Common Application Form
DEADLINE: February 19, 2014 at 1:00 PM
LATE APPLICATIONS WILL NOT BE ACCEPTED.
To apply for the fellowships listed below, you must upload this application form and all other required application materials to
the CIPE Summer Fellowships Common Application entry on the Student Grants Database. Application materials will not be
accepted via e-mail or in person. Please complete all fields below.
Applicant and Proposal Information
Last name:
Student ID number:
First name:
UPI:
Middle initial:
Residential College: Choose from list
Class year: Choose from list
Please provide a brief descriptive summary of your proposal. (For this and the following short-answer questions, use only the space
provided)
Cell phone:
Length of proposed activity:
Will you be off-campus (studying abroad, etc.) Spring 2014?
no or
yes
Proposed country/countries of travel:
Number of weeks:
**Note that many, but not all, fellowships require an 8 week minimum time commitment.**
Fellowships
- Check the box next to the fellowships for which you are applying using this Common Application Form.
- You must also register on the Student Grants Database for each individual fellowship you indicate here, as well as for the CIPE
Summer Fellowships Common Application.
*If you don’t check a box and/or don’t register for the corresponding fellowship, your application will not be considered for that
competition.*
Alexander P. Hixon Travel Fund
Robert Lyons Danly 1969 Memorial Travel Fellowship
Marshall Bartholomew Summer Arts Fellowship
Shana Alexander Research Fellowship in Women's, Gender,
and Sexuality Studies
Cohen Summer Public Service Fellowship
Solomon Research Fellowship in LGBT Studies
Franciscus Summer Travel Fellowship in Entrepreneurship
Summer Fellowship in Japan
Friedman Family Travel/Research Fellowship
Thomas C. Barry Travel Fellowship
GALA Summer Fellowship
Wendy E. Blanning Memorial Summer Fellowship
Jehiel R. Elyachar Foundation Travel Fellowship
William and Miriam Horowitz & David and Iris Fischer Judaica
Project Funds
CIPE Spanish & Latin American Fellowships
CIPE Summer Journalism Fellowships
Yale College Dean's Research Fellowship in the Humanities
and Social Sciences
Robert Bildner '72 and Elisa Spungen Bildner '75 Fellowship in
Contemporary and Historical Jewish Life in Israel and the
Diaspora
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Yale College Public Service Research Grant
Last name:
First name:
Middle initial:
UCS International Bulldogs Internships
Check if this fellowship application is for funding a UCS International Bulldogs Internship.
Have you already been offered and accepted the internship position? ( no) or (
yes)
If no, do you have other pending UCS International Bulldogs Internship applications? List them below:
Human Subject Committee Guidelines
All applicants must review the Yale University Institutional Review Board (IRB) Human Subject Committee’s guidelines on student
projects at www.yale.edu/hrpp/forms-templates/behavioral.html (click on “student projects”). Fellowship funding may be withheld
if IRB approval is required and not received.
After reviewing the IRB guidelines, does your project require IRB approval? ( no) or (
If yes, have you started the IRB approval process? ( no) or (
yes)
yes)
Project preparation
With which faculty members or others with relevant expertise have you thoroughly discussed your proposed idea? In the case of
independent projects and research, have any of these agreed to act as a mentor for the proposed activity? If so, in what ways will
this individual be involved?
What aspects of your proposed idea and/or preparation still need to develop, and how do you plan to address these before or while
you are carrying out your activity?
Other funding
List below all fellowships or awards not listed on this Common Application for which you have applied, will apply, or have won to
support this same or a similar project. If you have won, please specify award amount. Fellowship applicants are expected to notify
CIPE immediately if they receive any funding toward this or a similar project after submitting this application.
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Last name:
First name:
Middle initial:
Budget
Enter your total estimated expenses for each item below.
EXPENSE
Airfare [indicate departure and arrival airports]
Local travel (bus, train, car, etc.)
Visa fees
Immunizations
Health Insurance
Housing (including utilities)
Food (including bottled water)
Mobile phone (only for applicants traveling outside the U.S.)
Internet access (only for applicants traveling outside the U.S.)
University or other fees* [please list]
Supplies* [please list]
Other* [please list]
Amount (in U.S.
Dollars)
Total expenses:
* Briefly describe the * items below.
Funds available from other sources, if any (other fellowships you have won for this same project, etc)
(Subtract:)
TOTAL FUNDS REQUESTED:
CIPE fellowships do not cover:
 the purchase of equipment (such as camcorders, cameras, computers, lab equipment, etc) which will become the personal
property of the student. However, items such as photocopies, digital memory cards, etc. are valid expenses and may be
included.
 the Student Income Contribution for students on financial aid.
 stipends, lost wages, or living expenses other than the categories listed in the table above.
Please describe any supplies, fees, or other expenses marked with an asterisk (*) above.
Letter of Reference
You may only submit one letter of reference; additional letters will not be accepted. Letters of invitation or affiliation are not
necessary and will not be accepted (with the exception of applicants to the GALA Summer Fellowship). Your letter of reference
should be requested through the CIPE Summer Fellowships Common Application entry on the Student Grants Database using the
online solicitation system. Letters are expected to be received prior to the application deadline. Letters submitted late may not be
reviewed with your application.
Name and department of your recommender:
If doing an independent project or research, is your recommender the faculty mentor for the proposed activity? If not, who will
serve in this capacity?:
Check to indicate that you waive your right to read the letter of reference submitted on your behalf, and that you will not seek to
do so either while you are enrolled at Yale, or subsequently.
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Last name:
First name:
Middle initial:
Language Assessment
List the language(s) you will use to complete your proposed project:
Are you a native speaker of this language?
NO: Schedule an appointment with a Language Instructor to meet with you to assess your language ability.
You can ask a current or past Language Instructor you have had at Yale, or you may contact the appropriate language
department on campus to have one assigned to you. Once you have contacted your language evaluator and arranged a
meeting, you should request your evaluation through the CIPE Summer Fellowships Common Application entry on the
Student Grants Database using the online solicitation system. Your evaluator will then receive an e-mail with the evaluation
form attached and should complete this form and upload it prior to the application deadline.
Name and department of your language evaluator:
Number of years you have studied this language:
List all applicable language courses you have taken at Yale or elsewhere:
YES: You are not required to submit a language evaluation but should be prepared to demonstrate fluent speaking, writing,
reading, and aural comprehension, should you be asked.
Please note: If you are traveling to a non-English speaking country and do not speak the language, be certain to explain in your
proposal how you plan to accomplish your goals using only English.
Travel Policy and Terms
By submitting this application to the Center for International and Professional Experience you agree:


to the terms of the Yale University International Travel Policy for Yale College Students at
http://www.yale.edu/yalecollege/international/travel/policy.html.
to notify CIPE immediately if any of your registration information changes, if you receive funding from other sources for this
same time period, or if you receive funding for this or a similar proposal from other sources.
You must upload all fellowship application materials to the CIPE Summer Fellowships Common Application entry on the Student
Grants Database prior to the deadline of 1:00 PM on February 19, 2014. Applications will not be accepted via email or in person,
and late applications will not be accepted under any circumstances.
Type your full name below to “sign” this application:
Print a copy of this application form and save it for your records.
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