HEI-Sponsored Summer Fellowship Program for Undergraduate Students - Mentor Application Form

The Health Effects Institute (HEI) is launching a new, paid summer fellowship program in the United States to support and encourage rising junior and senior undergraduate students from underrepresented backgrounds to pursue environmental health sciences. The aim of the program is to provide a research experience in the environmental health sciences to students who might not otherwise have this opportunity. We recommend that as many of the activities as possible be held in person to foster relationships between the student and the mentor, other members of the laboratory or department, and other undergraduate students who are on campus during the same period. This form collects information on potential mentors for this program to share with student applicants. Please note that the program facilitator will match students to mentors based on the interests of the students. Thus, although the time and interest of all potential mentors are valued, we will most likely not be able to match a student with every potential mentor.

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* 1. Contact Information

Full Name

Preferred name for contact (not posted online)

Affiliation

Title / Position

Email address (not posted online)

Lab Website

Information on the opportunity you could provide

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* 2. Please provide a brief description of the type of project you would expect to provide. [100 word max]

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* 3. Fellows will receive training in the following skills (select all that apply)

Fieldwork

Data Analysis

Laboratory Analysis

Outreach

Applying for graduate schools or jobs

Communicating Science

Other (please specify)

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* 4. Who will be the primary direct supervisor of the student? (select one)

I will directly supervise

My postdoc will directly supervise

My PhD student will directly supervise

Someone else in my lab will directly supervise

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* 5. If you answered yes to any of the choices where you do not directly supervise, please fill out the appropriate boxes below. If not applicable, skip the question.

My postdoc will directly supervise (fill in name of postdoc if known)

My PhD student will directly supervise (fill in name of PhD student if known)

Someone else in my lab will directly supervise (fill in name and job title)

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* 6. How often will the student meet with their primary direct supervisor? (select one)

Daily

Weekly

Other (please specify)

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* 7. Will the student be working in-person, remotely, or in a hybrid setting?

In-person (preferred)

Hybrid

Remotely

Other (please specify)

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* 8. Which meetings will be in person?

Meetings with primary direct supervisor

Lab or group meetings

Departmental meetings

All meetings will be virtual (less preferred)

Other (please specify)

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* 9. Size of lab (short fill-in-the-blanks)

Faculty

Research staff

Postdocs

PhD students

Master’s students

Undergraduate students

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* 10. How many other summer research students at the undergraduate level will the student regularly interact with? Opportunities include through your lab, a student desk area, or departmental events.

This person will be the only undergraduate

2-5 undergraduates

6-10 undergraduates

> 10 undergraduates

Information about resource availability

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* 11. Other resources available to students (Select all that apply)

Desk/office space

Dedicated laboratory space

Laboratory supplies and access to equipment

Computer

Access to high-powered computing cluster

Specialized software

Departmental seminars

Professional development seminars

Presentations to lab group

Ability to attend trainings provided by other summer programs

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* 12. If you indicated access to trainings or seminars, please describe their frequency and duration

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* 13. Can your institution provide other financial or logistical support? (not required to be a mentor)

Yes, housing assistance

Yes, transportation to and from the site

Yes, matching funding

Yes, another type

I do not know

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* 14. If you indicated that your institution might be able to provide other financial or logistical support, please describe the nature of the support.

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* 15. Is there anything else you would like the applicant to know about the opportunity or resources? [100 word max]

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* 16. If matched with a fellow, do you agree to the following (must select all)?

Attend mentor training

Attend a networking event with all summer fellows at the beginning and end of the program

Provide the experience as indicated in my response, or change only after consultation with program organizers and matched fellow

HEI-Sponsored Summer Fellowship Program for Undergraduate Students - Mentor Application Form

Question Title

* 1. Contact Information

Question Title

* 2. Please provide a brief description of the type of project you would expect to provide. [100 word max]

Question Title

* 3. Fellows will receive training in the following skills (select all that apply)

Question Title

* 4. Who will be the primary direct supervisor of the student? (select one)

Question Title

* 5. If you answered yes to any of the choices where you do not directly supervise, please fill out the appropriate boxes below. If not applicable, skip the question.

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* 6. How often will the student meet with their primary direct supervisor? (select one)

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* 7. Will the student be working in-person, remotely, or in a hybrid setting?

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* 8. Which meetings will be in person?

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* 9. Size of lab (short fill-in-the-blanks)

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* 10. How many other summer research students at the undergraduate level will the student regularly interact with? Opportunities include through your lab, a student desk area, or departmental events.

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* 11. Other resources available to students (Select all that apply)

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* 12. If you indicated access to trainings or seminars, please describe their frequency and duration

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* 13. Can your institution provide other financial or logistical support? (not required to be a mentor)

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* 14. If you indicated that your institution might be able to provide other financial or logistical support, please describe the nature of the support.

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* 15. Is there anything else you would like the applicant to know about the opportunity or resources? [100 word max]

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* 16. If matched with a fellow, do you agree to the following (must select all)?

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* 17. Do you have anything that you would like the organizers to know, or have any questions? If so, please list your questions and feedback here.