Howard Hughes Medical Institute
Science and Math in Research & Teaching Fellowship
(HHMI-SMART) 2015 Application
I. Personal Information
Name:
Student ID:
Current Class Standing:
Birth Date:
Current Campus Address:
Permanent Address:
Whittier Email:
Personal Email:
Daytime Phone:
Evening Phone:
II. Academic Profile
Undergraduate Major(s):
Undergraduate Minor(s):
Which Program are you doing?
____ Liberal Education Program
____Whittier Scholars
Scholarships and or fellowships you currently hold:
Scholarships and or fellowships you are currently applying for:
III. Work Information
How many hours a week do you currently work (work study or off-campus)?
If you receive this fellowship would you be able to reduce the amount of hours your currently work? If so, how many
hours?
IV. Prospective HHMI-SMART Research Project & Graduate School Interests
Part A: Research
Current Research Interests in STEM (Science, Technology, Engineering & Math):
Part B: Teaching
Interested in Pursuing the Following Type(s) of Teaching Credentials (Check all that apply)
☐ Multiple Subject Credential (Grades K-6)
☐ Single Subject Credential (Grades 7-12)
If Interested in a Single Subject Credential, Please Indicate the Content Area(s)
☐ Physics
☐ Chemistry
☐ Biology
☐ Earth Science
☐ Math
Part C: Graduate Studies
Intended Graduate School Program:
☐ Teaching Credential Only
☐ Teaching Credential + MA/MEd in Education
☐ Other Graduate Program (Please Specify___________________________________________)
☐ Undecided
V. Personal Statement
In a separate and attached document, please describe how your interest developed to pursue a career in
math and/or science teaching (at any level) in 500 words or less. Provide examples of steps you’ve taken
outside of applying for this fellowship to pursue this career goal.
VI. Research Proposal
In a separate and attached document, please describe the focus of your intended research project in 800
words or less. Include in this description (1) your research question or hypothesis, (2) a synopsis of the
background and significance of the project, and (3) a proposed methodology for the project.
VII. SMART Program Essay
In a separate and attached document, please explain how you might teach a high school student about the
concepts related to your proposed research project in a classroom setting in 500 words or less.
VIII. References
1) In a sealed envelope (to be include with your application materials) a formal letter of reference from your
potential HHMI-SMART Faculty Advisor/Mentor (must be tenured/tenure track and not on sabbatical
throughout the duration of your fellowship).
2) Please provide the names of two faculty members who we may contact in regards to your academic and
scholarly abilities.
Name:
Department:
Name:
Department:
Please Note:
By signing this form, you both endorse your application and give Whittier College the permission to access
your current transcript-this transcript will become part of your HHMI-SMART file. Likewise, you affirm that
all of the statements made in this application are to the best of your knowledge and correct.
Signature:
Date:
HHMI-SMART UNDERGRADUATE FELLOWSHIP
STUDENT CONTRACT
Dear Prospective HHMI-SMART Fellow:
In accepting our offer for becoming a member of the HHMI-SMART Fellowship through Whittier College you have
read and agreed to abide by the below stated requirements. If you fail to meet the requirements it will result in possible
loss of your stipend and possible dismissal from the program.
HHMI-SMART Fellowship Requirements:
General
1. Complete eight weeks of full time summer research – two summers
2. Attendance at all HHMI-SMART Fellowship programing and required/mandatory meetings including but not
limited to:
a. Two week summer workshop with local high school teachers – two summers
b. Recruitment Sessions (Beginning in October/November)
3. Conference Attendance (will require travel)
a. HHMI-SMART Fellows are encouraged to participate in conferences to disseminate their research
and/or experiences in designing high school math/science curricular materials.
4. Participate in evaluation of HHMI-SMART Fellowship Program.
Research-Related:
1. Each Fellow is required to conduct an individual research project under the guidance of an HHMI-SMART
Faculty Mentor.
2. You will create and update a Research Timeline that will be an overview of your research from the start to the
completion of your research project.
3. You will submit progress reports twice a semester, signed by the mentor reporting on the progress that has
occurred. Progress reports are due two weeks prior to each pay period. It is the Fellow’s responsibility to
develop and submit a signed (signed by their HHMI-SMART Faculty Mentor) progress report.
4. Write a final report on your research project consistent with a manuscript submission in your field.
5. Attend regular meetings with your HHMI-SMART Faculty Mentor (weekly or twice a month)
Teaching-Related
1. Complete at minimum 30 hours of fieldwork (~2 hours per week) in a high school math or science classroom
each semester of your two year commitment.
a. During this fieldwork, you will work alongside the high school classroom teacher to implement
math/science curriculum that embodied the type of pedagogy discussed during summer workshop.
b. Fieldwork hour log sheets will be signed by high school classroom teacher and then submitted to Log
to HHMI-SMART Program Coordinators
2. Enroll in a one-unit seminar course (EDUC067) to discuss experiences in high school classroom
a. Complete all assignments and reflections associated with the course.
3. Attend four follow-up workshops with the high school teachers – these will be scheduled during the academic
year.
I agree to abide by the requirements state above and understand if I do not fulfill all requirements I could lose
all or a portion of my stipend and also be dismissed from the program.
Print Name:
Signature:
_______________________________________ Date: ___________________
_______________________________________
HHMI-SMART Faculty Mentor:
Print Name:
_______________________________________
Signature:
_______________________________________
Spring 2015 Academic Progress Report
Student Name:______________________________ Student ID#:_________________
Course Name:______________________________________
Professor/Instructor Name: ______________________________________
Attendance:
___ Poor
___ Fair ___ Good
___ Excellent
Completion of Assignments:
___ Poor
___ Fair ___ Good
___ Excellent
Participation:
___ Poor
___ Fair ___ Good
___ Excellent
Approx. Overall Course Standing:
__100-90%
__89-80% __79-70% __69-60% __59-0%
Comments:_____________________________________________________________________________________________
______________________________________________________
Professor/Instructor Signature:_____________________________________________________
Course Name:______________________________________
Professor/Instructor Name: ______________________________________
Attendance:
___ Poor
___ Fair ___ Good
___ Excellent
Completion of Assignments:
___ Poor
___ Fair ___ Good
___ Excellent
Participation:
___ Poor
___ Fair ___ Good
___ Excellent
Approx. Overall Course Standing:
__100-90%
__89-80% __79-70% __69-60% __59-0%
Comments:_____________________________________________________________________________________________
______________________________________________________
Professor/Instructor Signature:_____________________________________________________
Course Name:______________________________________
Professor/Instructor Name: ______________________________________
Attendance:
___ Poor
___ Fair ___ Good
___ Excellent
Completion of Assignments:
___ Poor
___ Fair ___ Good
___ Excellent
Participation:
___ Poor
___ Fair ___ Good
___ Excellent
Approx. Overall Course Standing:
__100-90%
__89-80% __79-70% __69-60% __59-0%
Comments:_____________________________________________________________________________________________
______________________________________________________
Professor/Instructor Signature:_____________________________________________________
Course Name:______________________________________
Professor/Instructor Name: ______________________________________
Attendance:
___ Poor
___ Fair ___ Good
___ Excellent
Completion of Assignments:
___ Poor
___ Fair ___ Good
___ Excellent
Participation:
___ Poor
___ Fair ___ Good
___ Excellent
Approx. Overall Course Standing:
__100-90%
__89-80% __79-70% __69-60% __59-0%
Comments:_____________________________________________________________________________________________
______________________________________________________
Professor/Instructor Signature:_____________________________________________________
Course Name:______________________________________
Professor/Instructor Name: ______________________________________
Attendance:
___ Poor
___ Fair ___ Good
___ Excellent
Completion of Assignments:
___ Poor
___ Fair ___ Good
___ Excellent
Participation:
___ Poor
___ Fair ___ Good
___ Excellent
Approx. Overall Course Standing:
__100-90%
__89-80% __79-70% __69-60% __59-0%
Comments:_____________________________________________________________________________________________
______________________________________________________
Professor/Instructor Signature:_____________________________________________________
Course Name:______________________________________
Professor/Instructor Name: ______________________________________
Attendance:
___ Poor
___ Fair ___ Good
___ Excellent
Completion of Assignments:
___ Poor
___ Fair ___ Good
___ Excellent
Participation:
___ Poor
___ Fair ___ Good
___ Excellent
Approx. Overall Course Standing:
__100-90%
__89-80% __79-70% __69-60% __59-0%
Comments:_____________________________________________________________________________________________
______________________________________________________
Professor/Instructor Signature:_____________________________________________________
Application Materials and Check List:
****The Deadline is: Friday February 27, 2015 by 5:00 pm ****
Please enclose the following items into one large envelope and deliver to the office of Dr. David Bourgaize,
located in the Stauffer Science Building, 4th floor, room SC408B.
__ Your Signed and Completed Application
__ Your Student Contract signed by you and your HHMI-SMART Faculty Mentor
__ Your Spring Academic Progress Report for current courses
__ Personal Statement (500 words)
__ HHMI-SMART Program Essay (500 words)
__ Research Project Proposal (800 words)
__ Sealed letter of recommendation from your Potential SMART Program Faculty Advisor/Mentor
Important Dates to Remember:
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Application Deadline: Feb 27, 2015 by 5pm as a hard copy to Dr. Bourgaize in his office (SC408?).
Student Interviews: Week of March 9 through 13, 2015
Final Decision: March 27, 2015
HHMI-SMART Program Two week Summer Program: TBD (Typically, the institute occurs last
two full weeks of June)