CORNELL GLOBAL HEALTH TRAVEL GRANTS The Cornell Global Health Program values applied global health learning experiences. To this end, funding is available to provide financial assistance to Cornell University undergraduate students conducting short-term research and/or volunteering in resource poor countries outside the United States. The purpose of the Global Health Minor Field Experience requirement is to challenge students to apply their classroom learning and skills in a field setting. Priority will be given to students who seek a mentored research and internship opportunity in a resource poor setting where the student has not had previous experience. Awards will be based on availability of resources and the quality of the student proposals. These grants will provide travel support up to $1000 for Cornell University undergraduate students conducting short-term research and/or volunteering in resource poor countries outside the United States. Eligibility and Requirements Who should apply? Students should only apply if, they: Intend to complete the requirements for the Global Health Minor. Have taken or are currently enrolled in NS 2600. Have a well-organized 8-week field experience in a health-related field planned for Summer 2011. Have a letter of invitation and/or approval from a sponsoring organization. Proposals will be automatically rejected if documentation of approval/support is not included in the application. How do I apply? Applications will be made available on Monday, March 14, 2011. Complete the attached application and submit three copies with your recommendation letter to Jeanne Moseley by Friday, April 1, 2011. You can submit the application materials directly to her on that day in Savage Hall B15 or drop off in her mailbox, which is located in Savage Hall 124. Applications submitted after this date will not be reviewed. The application should include a copy of your resume, detailed budget and one recommendation letter from a faculty member who knows you well and can speak to your ability to successfully complete your field experience this summer. Each recommendation letter should be submitted in a sealed envelope with the signature of the recommender across the sealed flap. When will I find out if my application has received funding? We will notify students by Thursday, April 14, 2011. 1 GLOBAL HEALTH TRAVEL GRANT APPLICATION Student Information Name: E-mail: Telephone: College: Major: Year of Graduation: Minor Requirements - What have you completed? Introduction to Global Health Semester _________ Year_____ Student Selected Core Course Semester _________ Year_____ □NS 3060 – Nutritional Problems of Developing Nations □NS 4450 – Food Policy for Developing Countries □NS 4570 – Health, Poverty and Inequality: A Global Perspective □ENTOM 2100 – Plagues and People □ANTHR 2468 – Medicine, Culture and Society □ANTHR 4862 – Healing and Medicine in Africa □AEM 2000 – Contemporary Controversies in the Global Economy □B&SOC 2051 – Ethical Issues in Health and Medicine □HE 4060- Diversity in Fieldwork and Professional Practice □HE 4900 - Multicultural Practice □HE 4950 – Culture, Medicine and Professional Practice in a Diverse World: New York Two Approved Elective Courses Course Title and Number: _________________________________________ Semester _________ Year_____ Course Title and Number: _________________________________________ Semester _________ Year_____ Type of Experience □ Research with Cornell Professor □ Volunteer Service Project □ Internship 2 Site Information Country: Specific location: Affiliation in country (University, hospital, local organization, Ministry of Health, etc…): In-country supervisor: Site contact person (if different from supervisor): Address: Telephone: Fax: E-mail: Length of Stay (submit a detailed itinerary with your proposal): Date of arrival: Date of departure: Have you done the following? □YES or □NO Obtained medical travel advice and immunizations appropriate for host country. Gannett Travel Clinic provides care essential for international travelers. If your plans involve world travel, be sure that you take full advantage of this convenient campus resource. http://www.gannett.cornell.edu/medical/travelservices.html □YES or □NO Gathered information concerning any political problems, safety concerns, or health hazards by consulting the US State Department (www.travel.state.gov/travel) and Centers for Disease Control and Prevention (CDC) (www.cdc.gov/travel) websites. □YES or □NO Is this country on the State Department warning list (www.travel.state.gov/travel)? □YES or □NO Investigated visa and other entrance requirements that may be enforced in the host country. Register with the US Embassy on the State Department website prior to departure. □YES or □NO Purchased medical/evacuation insurance policy to cover the duration of the overseas experience. The link below provides travel-related information and services offered directly through Cornell offices and elsewhere in the federal government and private sector—including translation, world clock, weather, and currency tools. http://www.international.cornell.edu/topic/travel/ This page is also Cornell’s official link to MEDEX Assist, a free insurance program available to members of the Cornell community traveling abroad on university business. 3 DESCRIPTION OF FIELD EXPERIENCE Answer the questions below: 1. What do you plan to do? (Describe your anticipated role & responsibilities) 2. What have you been doing to prepare for this experience? 3. How do you hope to contribute to the mission of the organization and/or the local people with whom you will be working? 4. What do you hope to gain from this experience (learning objectives, personal development, effect on academic goals and effect on career goals)? 4 ESTIMATED BUDGET FOR FIELD EXPERIENCE Include detailed information about the following items: Travel Cost (airfare and in-country transportation) Immunizations Visa and passport fees Room and board while at the field site ATTACH RESUME & LETTER OF INVITATION/SUPPORT 5