Academic Mentor Recommendation Form
Dear Colleague:
You have been identified as an academic mentor for an individual applying for the Doris Duke
Fellowships for the Promotion of Child Well-Being, sponsored by the Doris Duke Charitable
Foundation and Chapin Hall at the University of Chicago. The primary responsibilities of the
academic mentor are supervising the fellow’s research, guiding the fellow toward completion of
the dissertation, and guiding the fellow’s career choices.
In addition to supporting the applicant, Chapin Hall hopes the academic mentors will seek
opportunities to develop and lead learning opportunities with other fellows who share a common
research, policy or methodological interest. Chapin Hall will support the development of these
groups and create opportunities for mentors to share their experiences with other mentors and
fellows in ways that foster interdisciplinary learning.
Please answer the following questions regarding the applicant’s qualifications and your proposed
strategy for mentoring the applicant’s work.
Instructions for Submission:
Please email the completed form to ddfellowship@chapinhall.org. Include the applicant’s name
and “Academic Mentor Form Submission” in the subject line of the email.
Please save your recommendation form in one of the following formats: .doc, .docx, or .pdf. The
file name should be in the following format: Applicant Name-Academic Mentor Form 2015.doc
You will be sent a confirmation email within 24 hours of when your submission is received.
If you would like additional information on the fellowship program or have any questions, please
email ddfellowship@chapinhall.org or visit our website at
http://www.chapinhall.org/fellowships/doris-duke-fellowships
Doris Duke Fellowships for the Promotion of Child Well-Being
Page 1 of 3 - 2015 Academic Mentor: Recommendation Form – Cohort Six
BASIC INFORMATION
All questions are required. Please use space as needed. Form fields will expand automatically.
Your Name
Your Title
Your Academic Institution
Your Email Address
Applicant’s Name
Applicant’s Academic Institution
APPLICANT QUALIFICATIONS
All questions are required. Please use space as needed. Form fields will expand automatically.
How long and in what capacity have you worked with the applicant?
What is your assessment of the applicant’s research potential?
What is your assessment of the applicant’s leadership abilities? Please provide an example
of a situation where the applicant displayed leadership skills.
What types of leadership roles do you anticipate this student will be engaged in 10 years
from now?
What are the applicant’s most outstanding attributes?
Doris Duke Fellowships for the Promotion of Child Well-Being
Page 2 of 3 - 2014 Academic Mentor: Recommendation Form – Cohort Five
What do you perceive to be the applicant’s weaknesses?
Of all the students you have mentored in your career, where does this student fit (e.g., are
they in the top 20% top 5%)?
MENTORING RELATIONSHIP
All questions are required. Please use space as needed. Form fields will expand automatically.
Please briefly outline your proposed approach to providing ongoing supervision and
guidance to the applicant.
Are you willing to participate in the opportunities the fellowship will provide to interact
with other fellows as well as other mentors?
Yes
No
Unsure at this time
If yes, please indicate the content and methodological areas in which you would be willing
to provide learning opportunities for fellows.
Thank you for completing this recommendation. The application period ends December 1 st
and selection decisions will be completed by April 30, 2016.
Email the completed form to ddfellowship@chapinhall.org
Doris Duke Fellowships for the Promotion of Child Well-Being
Page 3 of 3 - 2014 Academic Mentor: Recommendation Form – Cohort Five