TO BE COMPLETED BY APPLICANT: To complete your application, please provide your name and signature below. Your signature indicates your availability, if selected, to prepare for and fully participate in the One Health Fellowship as indicated above. It also indicates your willingness to provide support, mentorship and constructive feedback for future Fellows. Applicant Signature Date Applicant Full Name TO BE COMPLETED BY APPLICANT’S CURRENT SUPERVISOR: To ensure that each candidate is able to participate fully in this fellowship, we require confirmation from the candidate’s current supervisor affirming support of this application. Your name and signature below affirms that you will allow the candidate time away from work to travel to the United States for 6 weeks (May-June 2019), to attend an international conference in Kenya (July 2019), to participate fully in evening and weekend training sessions in Kigali, and to conduct their follow-up projects (September 2019 to April 2020). Supervisor Signature Date Supervisor Full Name Please submit this application via email by February 8th, 2019 and direct any questions to: OneHealthFellowship@tufts.edu Tufts Cummings School of Veterinary Medicine, Department of Infectious Disease and Global Health 200 Westboro Road, North Grafton, MA 01536 Tel +15088874208 Remember to submit your CV or resume with this application form SAMPLE BIO Hellen Amuguni
TO BE COMPLETED BY APPLICANT: To complete your application, please provide your name and signature below. Your signature indicates your availability, if selected, to prepare for and fully participate in the One Health Fellowship as indicated above. It also indicates your willingness to provide support, mentorship and constructive feedback for future Fellows. Applicant Signature Date Applicant Full Name TO BE COMPLETED BY APPLICANT’S CURRENT SUPERVISOR: To ensure that each candidate is able to participate fully in this fellowship, we require confirmation from the candidate’s current supervisor affirming support of this application. Your name and signature below affirms that you will allow the candidate time away from work to travel to the United States for 6 weeks (May-June 2019), to attend an international conference in Kenya (July 2019), to participate fully in evening and weekend training sessions in Kigali, and to conduct their follow-up projects (September 2019 to April 2020). Supervisor Signature Date Supervisor Full Name Please submit this application via email by February 8th, 2019 and direct any questions to: OneHealthFellowship@tufts.edu Tufts Cummings School of Veterinary Medicine, Department of Infectious Disease and Global Health 200 Westboro Road, North Grafton, MA 01536 Tel +15088874208 Remember to submit your CV or resume with this application form SAMPLE BIO Hellen Amuguni
One-Health-Fellowship-Application-Form.docx