2015 CARLSON CIVIC FELLOWSHIP APPLICATION
University of Washington’s Carlson Leadership & Public Service Center
INSTRUCTIONS
Please send completed applications as Word and PDF attachments to engage@uw.edu by 5:00 PM on Tuesday,
October 21, 2014. Applications received after the deadline will not be accepted.
Questions? Contact Talya Gillman, at 206-543-4282, engage@uw.edu, or visit MGH 171.
I. PERSONAL INFORMATION
Name:
Student Number:
Phone:
Email:
Your Studies:
Major(s):
Minor(s):
Expected Year of Graduation:
II. FELLOWSHIP INTERESTS
Which of the three community partner organizations are you interested in working with as a Carlson Civic Fellow?
(Multiple organizations may be selected.)
For full position descriptions please visit: http://depts.washington.edu/leader/fellowships/carlsonfellows.html.
Entre Hermanos
International Rescue Committee
Seattle Chinatown International District Preservation and Development Association
III. SHORT ANSWER QUESTIONS
Respond to each of the following questions in the boxes below, limiting your responses to 250 words or less.
1.
Please explain why you are interested in working with the community organization(s) you indicated above. (If
you are applying for multiple positions, please provide a separate short answer for each organization.)
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2.
Why are you interested in being a Carlson Civic Fellow? How will the structure of this program (leadership
courses, advising, etc.), the experience working with a community organization, and the $2,500 stipend
advance your ability to serve and lead in the community?
3.
We are looking for students who have shown dedication to activities of importance in their lives. Please tell us
about a school, community, work, family, or extracurricular responsibility to which you have been most
committed. Specify the length/frequency of commitment and any positions held. Please note any significant
accomplishments achieved or challenges you have overcome while participating in this activity. You might
also comment on what you have learned about yourself through the experience.
4.
What social problem do you think is the most urgent crisis in your community and/or in today's society at
large? Why is this issue important to you?
5.
Describe an experience working with someone different from you. What did you learn from it?
6.
Are you currently receiving financial aid (grants, work-study, loans)? (Note that this is for informational purposes
only. Federal financial aid status is not a deciding factor in the Carlson Civic Fellows application process.)
Yes
No
If yes, please provide details:
IV. FELLOWSHIP COMMITMENTS
1.
If selected as a Carlson Civic Fellow, will you commit a minimum of 10 hours per week to Carlson Fellowship
activities at your community organization from January through June 2015? Yes
No
2.
If selected as a Carlson Civic Fellow, will you commit to monthly check-in meetings with Carlson Center staff to
assess progress toward your Carlson Civic Fellowship goals? Yes
No
3.
If selected as a Carlson Civic Fellow, will you commit to taking a three-credit Community-Based Leadership
course during Winter Quarter (or Spring Quarter, if extenuating circumstances arise)? Yes
No
4.
If selected as a Carlson Civic Fellow, will you commit to participating in an MLK Day of Service project on
Monday, January 19, 2015? Yes
No
5.
If selected as a Carlson Civic Fellow, will you commit to preparing and presenting a poster presentation at the
Spring Celebration of Service and Leadership on Tuesday, May 20 (time TBD)? Yes
No
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V. REFERENCES
In the space below, please provide contact information for two individuals (excluding family members) who are
familiar with your community involvement and/or family responsibilities. Include their name, how you know the
person, their phone number and email address (if available), and a note about how you know the person.
Reference 1 Name:
How you know this person:
Phone:
Email:
Reference 2 Name:
How you know this person:
Phone:
Email:
IV. INTERVIEW PROCESS
The Carlson Civic Fellowship Interview Process has two components. Students with outstanding applications will
be invited to a first round interview with representatives from the Carlson Center and the University of
Washington. A select group of students will then be invited for a second round interview with representatives
from the community organization at which they are applying to serve as a Fellow.
1.
First Round Interviews will be scheduled on Monday, November 3 and Tuesday, November 4 between the
hours of 12:00-6:00 PM. In the space below, please note any times within these two time frames that you
are unavailable for an interview.
2.
Second Round Interviews will take place on Friday, November 7 between the hours of 5:00-8:00 PM. In the
space below, please note any times within this time frames that you are unavailable for an interview.
Applicants who engage in a Second Round Interview will be notified of final decisions by Wednesday, November 12.
Thank you for your application!
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