Copy of Zach Miller - Engineering World Health

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					                         Engineering World Health Summer Institute

                                 Hudson 136, BME, Box 90281, Durham, NC 27708




Before You Begin

The application is divided into six sections (outlined at the left).
To edit longer text within the cell or to cut and paste into a cell, double click on the cell; or edit in the formula bar.

REQUIREMENTS FOR CONSIDERATION

                  To be considered for the Summer Institute, you must have completed two semesters of
                  physics with calculus by June 2011.

                  Applications received after January 7, 2011, will not be considered for financial aid.
                  Applications received after January 28, 2011 will be automatically waitlisted.
                                        * Many applications are accepted from the wait list each year.


                  Note that a $45 nonrefundable application fee payable online by credit card is required
                  in order to submit your application.

SUBMITTING YOUR APPLICATION

                  Applications must be completed electronically and can be saved repeatedly until you submit.
                  Note: save this application as an Excel 2003 document (compatibility mode) and not an Excel 2007 document.
                  Use "Save as" to include your name in the file name:
                  <Replace with your first and last name>_EWH_app2011.xls.

                  Your application is not considered complete until we receive the following:
                                   -Application
                                   -Application fee
                                   -Scanned transcripts
                                   -Recommendation letter
                                   -Financial aid application (if applicable) including all supporting
                                    tax documentation

                  To submit your application, go to www.ewh.org then to the Duke Summer Institute submission page.

ACCEPTANCE PROCEDURES

                  You must submit a completed application to be accepted.

                  After submitting the application, you may be interviewed by an EWH staff member or volunteer.

                  If accepted, you must submit a non-refundable deposit ten days after notification (including
                  fellowship students). After we receive your downpayment, you will be sent an
                  acceptance packet with additional forms to complete.

                  Applicants wishing to apply for financial aid must complete a separate form and submit tax
                  documents at the time of application. The EWH SI Financial Aid Application can be found on
                  the EWH website and can be submitted along with the tax documents to info@ewh.org




I. Preliminary Information

Today's Date (MM/DD/YYYY)                                     11/8/2010

If you are an EWH Chapter member, please
list the EWH chapter. Otherwise, leave blank.

Are you applying for financial aid?                           No

The Central America and Africa programs are slightly different programs. Please read the materials in the
application packet regarding each program site very carefully to determine your preferred placement. Both
programs are open to citizens of any nation.
                  * Note that each program's dates are different (Africa: 6/22-8/21, Central America: 6/1-7/31)


Do you have a preference?                                     No

If yes, why?




If you are not accepted to your preferred                     Yes
program, would you consider participating in
the other program?
                  * Note that your chances of being accepted are increased if you are willing to participate in either program.


Are you applying for the DHT Lab 1 year                       No
volunteer internship?
                  * Please refer to the application packet for details


Are you applying for the EWH 1 year                           No
volunteer internship?
                  * Please refer to the application packet for details


Are you applying for the family program                       No
(bring your spouse and/or children with you)?
                  * See application packet for more information on this program
II. Contact Information

Participant

First Name                                                 Zachary
Last Name                                                  Miller
                                                                                * Names should be as they appear on your passport


If you prefer a nickname, please enter it here.

Current Address 1                                          765 Hunt Club Trail
Current Address 2
City/town                                                  Port Orange
State/Province/Region                                      Fl
Zip/Postal Code/Postcode                                   32127
Country                                                    United States

Permanent Address 1
Permanent Address 2
City/town
State/Province/Region
Zip/Postal Code/Postcode
Country
                 * If your permanent address is your current address, then fill in the same address for both.


Telephone (work)                                           (386)-761-7669
Telephone (home)
Telephone (dorm)
Telephone (cell)
Telephone (fax)
                 * Enter US numbers in the format xxx-xxx-xxxx. If entering an international number, please include country code.


E-mail Address 1                                           zam4@duke.edu
E-mail Address 2
                 * Email Address 1 should be your primary email account that you check most frequently



Mother

First Name                                                 Jackie
Last Name                                                  Miller

Address 1                                                  765 Hunt Club Trail
Address 2
City/town                                                  Port Orange
State/Province/Region                                      Florida
Zip/Postal Code/Postcode                                   32127
Country                                                    United States

Telephone (home)                                           (386)-761-7669
Telephone (work)                                           (386)-248-0832
                 * Enter US numbers in the format xxx-xxx-xxxx. If entering an international number, please include country code.


E-mail Address 1
E-mail Address 2
Father

First Name                                               Mark
Last Name                                                Miller

Address 1                                                765 Hunt Club Trail
Address 2
City/town                                                Port Orange
State/Province/Region                                    Florida
Zip/Postal Code/Postcode                                 32127
Country                                                  United States

Telephone (home)                                         (386)-761-7669
Telephone (work)                                         (386)-248-0832
                * Enter US numbers in the format xxx-xxx-xxxx. If entering an international number, please include country code.


E-mail Address 1                                         mark_miller66@bellsouth.net
E-mail Address 2


Do we have permission to contact your                    yes
parents regarding the Summer Institute?




III. Participant Profile

Date of Birth (MM/DD/YYYY)                               9/10/1990

College/University Name 1 (most recent)                  Duke
Major or Department                                      Biomedical Engineering
GPA in major                                             3.96
Expected Graduation Date (MM/YYYY)                       5/1/2013
Degree (Bachelors, Masters, Doctorate)                   Biomedical Engineering

College/University Name 2
Major or Department
GPA in major
Expected Graduation Date (MM/YYYY)
Degree (Bachelors, Masters, Doctorate)

College/University Name 3
Major or Department
GPA in major
Expected Graduation Date (MM/YYYY)
Degree (Bachelors, Masters, Doctorate)

Gender (M/F)                                             Male
                * EWH is coed, but participants live and work in same sex pairs.
Nationality of passport you will travel under,              United States
should you attend the Summer Institute.

How did you hear about the Engineering World
Health Summer Institute? If other, please list:             friend

Name of local University sponsoring an EWH
Chapter        * If applicable, even if you aren't a member


Number of hours you have attended EWH               n/a
Chapter events, e.g., repair sessions (if applicable)
                   * Participation in EWH activities increases your chance of admission


Are you applying under an EWH Chapter
Fellowship program?

If yes, name of sponsoring chapter.

How many physics courses with calculus and                  2
labs have you had?

How many chemistry college courses with labs                4
have you had?

How many zoology/biology courses with labs                  2
have you had?

Have you taken a circuits course?                           yes

Have you taken an instrumentation course?                   yes

If your native language is not English, state your
native language(s) and describe your level of
English reading, writing, and speaking
proficiency.




Have you studied a foreign (non-native)                     yes
language?

If so, indicate how many semesters (either in high school or college) you have studied, and describe your level
of experience (high school, AP, university, immersion programs…).

                   Language 1                               Spanish
                   Semesters                                high school-8 semesters
                   Level                                    advanced

                   Language 2
                   Semesters
                   Level

                   Language 3
                   Semesters
                   Level

Please list your extra-curricular activities,               Volunteer at hospital
including any organizations in which you are
involved.




Please list any special accomplishments,                    2009-present Robert C. Bird Undergrad $6000 Scholarship
awards, honors or leadership positions (club                2007-National Merit Commended Scholar
officer, etc.).
IV. Essays

* Each essay response should be less than 250 words. Your answer will be electronically truncated at 250 words upon submission.
* We recommend writing your essay in a word processor (like MS Word) and cutting and pasting into the essay cells.
 To cut and paste or to edit within the cell, double click on the cell when selected. You may also hit F2 or edit within the formula bar.


A)
Do you have previous experience
troubleshooting:
                 in class?                                     no

                    outside of class?                          yes

If you have troubleshooting experience outside of class, please describe.

                                                               Summer of junior year I worked at the Jewish Federation of Volusia/Flagler
                                                               counties converting a Mac based client database to Windows XP Microsoft
                                                               Access. Now, reader you are probably thinking the same thing I was: this job
                                                               should be easy and only take a couple of days. Unfortunately, I had not been
                                                               told that the Mac operating system was not a 2008 or a 2000 or even say a
                                                               1995 operating system. Instead I was handed a 1985 computational
                                                               monstrosity that utilized around the same memory as a floppy disk. The job as
                                                               explained to me by the nice, although computer illiterate seventy year old
                                                               director of the charity was to transfer ten thousand plus client records from
                                                               Apple to Windows. Apparently, someone had told her it was not the best idea
B)
Describe any previous experience in a clinical setting (shadow days in a hospital, clinic, veterinary etc.).

                                                               In the oncology unit to survive or to begin to understand flexibility is required.
                                                               It is impossible to adapt to death or pain or suffering, it is impossible to be
                                                               open-minded about cancer. My forty hours working in the oncology ward
                                                               (easily some of the most crucial and important of my life) forced me to see
                                                               and feel the spectrum of human life and suffering. Flexibility is listening to a
                                                               patient be told they have terminal cancer, and fifteen minutes later listening to
                                                               another person told they are cancer free. Flexibility is learning about the
                                                               cancer I want to treat by touching (with gloves) an anal-rectal tumor, speaking
                                                               to a homeless man who thought I was the doctor (he handed me the
                                                               insurance, the prescriptions, everything), recognizing how much the five
C)
Describe an experience encountering and overcoming a language barrier.

                                                               My senior year high school Spanish teacher, all four foot nine of her, was the
                                                               terror of the graduating class. She would glance at many a poor student, and
                                                               explain carefully to them in words they struggled to understand, “cuatro anos y
                                                               nada…four years and you have learned nothing.” Her classroom was an
                                                               island that had floated from Columbia replete with communists, the CIA, Old
                                                               school Catholicism, and many an interesting story. Clearly to most students
                                                               she was a terror to behold. I felt the same way when she first began speaking
                                                               Spanish. I had trouble following her accent, I was frightened by her outbursts,
                                                               and I was scared for my GPA. However as the days went on, I began to follow
                                                               not only her Spanish, but the Spanish of those outside the classroom. I could
D)
Have you ever traveled outside of the United                   yes
States (or other home country)?

If so, list countries to which you have traveled.              Mexico, Puerto Rico, Canada




Have you ever lived outside of the United                      No
States?

If so, list countries where you lived and number
of months you were there.
(e.g. Costa Rica-24, …)




E)
Describe your experiences traveling alone, foreign or domestic.

                                                               I wish I could say I travelled around the globe alone. Unfortunately, I have
                                                               lived a sheltered, upper middle class life that has involved being tightly held by
                                                               my parents at all times. College was the first big adventure outside of the
                                                               familial home, and it also has been the toughest time of my life. My mom used
                                                               to speak of riding the city bus as a sign of truly growing up. When my parents
                                                               worried and objected to EWH, explaining to me the multitude of ways I could
                                                               die, get blown up, get caught in political activism for either the Somozas or
                                                               Sandinastas, get kidnapped, catch various fevers, get eaten by animals, I
                                                               reminded them of that city bus trip. I have to have my chance to grow up, to
                                                               see the world apart from my easy American perspective. Now is the time I ride
F)
Working and living in the developing world can be difficult. Describe the most challenging conditions you have
experienced.
                                                 Summer of high school going into senior year I lived with three sophomores at
                                                 a University of Florida science camp. I really would like to have said it was a
                                                 positive experience that taught me about group dynamics, how easy it is to
                                                 make friends with other people, but in reality this experience taught me just
                                                 how difficult it is to form new relationships with people you have been thrown
                                                 into a 300 square foot space with. Going into the camp, I expected most of the
                                                 students there would be hardworking, smart, and not likely to have any
                                                 psychological issues... how wrong I was. Lets start with my roommate: Bryan.
                                                 Bryan soon after his mother left began speaking in detail about the various
                                                 drugs he tried. My other roommate Tim liked to climb up on the top post of the
G)
Why do you want to participate in the Engineering World Health Summer Institute?

                                                               I wish I could say I am a model applicant, but when I look at my resume or I
                                                               try to think through the Earth shattering events in my life I see mostly blanks,
                                                               unwritten spaces. You see, I have spent most of college holed up in my dorm
                                                               room, studying or staring at a computer screen, and when I ask myself if I am
                                                               happy with what I have, who I am, anything really, the resounding answer is
                                                               no. I am applying to this program because I need a change, I need to shake
                                                               this horribly cynical worldview I have developed over the last year and maybe
                                                               learn to love life again???and this program sure as hell will force me too. The
                                                               Nicaragua EWH program seems to fit into the bits and pieces of who I am,
                                                               who I want to be. I have had four years of Spanish, and I miss not speaking
V. Transcripts

Scan your transcripts (official or unofficial) or report cards from all universities listed at 150 dpi, black&white.

Submit the scanned copies with your application.




VI. Recommendation Letter

Select a faculty member or other person who can comment on your technical abilities.

They must fill out the Recommender form found in this packet and email it to dukesummerinstitute@ewh.org
by the application deadline (Jan. 7, 2011 for financial aid applicants; Jan. 29, 2011 for all others).

Please provide us with information about your recommender…

First Name                                                Gloria
Last Name                                                 Max

Work Address 1                                            470 Andalusia Avenue
Work Address 2
City/town                                                 Ormond Beach
State/Province/Region                                     Fl
Zip/Postal Code/Postcode                                  32127
Country                                                   United States

Telephone (work)                                          (386)-672-0294
                 * Enter US numbers in the format xxx-xxx-xxxx. If entering an international number, please include country code.


Email Address                                             FEDVF@aol.com
                                         If you are a
              I.                         EWH Chapter                   Are you
Excel         Preliminary                member,        list the EWH   applying for
formatting    Information Today's Date   please         chapter        financial aid?

    DATA
 VALIDATION

Type                       date

List                                                                   yes
                                                                       no
All programs      Please read the                                   If yes, why?
are open to       materials in the
citizens of any   application
nation. The       packet
Central           regarding each                                                    Would you
America and       program site       your preferred Do you have a                   consider
Africa programs   very carefully to placement.      preference?                     participating in




                                                                    text

                                                  Yes, I prefer the Africa program (6/2/09-7/31/09).
                                                  Yes, I prefer the Central America program (6/17/09-8/15/09).
                                                  No, I have no preference. I can participate in either program.
                          Are you                                         (bring your
                          applying for the               Are you          spouse and/or
             the other    Duke-EWH 1       volunteer     applying for the children with   II. Contact
             program?     year             internship?   family program you)?             Information




               Yes                        Yes                            Yes
               No                         No                             No
pate in either program.
                                       I prefer my   Current     Current
Participant   First Name   Last Name   nickname      Address 1   Address 2
                               Permanent   Permanent
City   State   Zip   Country   Address 1   Address 2
                               Telephone   Telephone
City   State   Zip   Country   (work)      (home)
Telephone   Telephone                   E-mail Address E-mail Address
(dorm)      (cell)      Telephone (fax) 1              2                Mother
First Name   Last Name   Address 1   Address 2   City   State
                Telephone   Telephone   E-mail Address E-mail Address
Zip   Country   (home)      (work)      1              2
Father   First Name   Last Name   Address 1   Address 2   City
                        Telephone   Telephone   E-mail Address
State   Zip   Country   (home)      (work)      1
                               parents
               Do we have      regarding the
                                               III.                           College/Univers
E-mail Address permission to   Summer          Participant                    ity Name 1
2              contact your    Institute?      Profile                        (most recent)
                                                             Date of Birth (MM/DD/YYYY)




                                                             date

                               Yes
                               No
Major or                     Exp Year                    College/Univers Major or
Department   GPA in major    Graduation   Degree Level   ity Name 2      Department




                              4 char
             #, 3 decimal places

                                          Bachelors
                                          Masters
                                          Doctorate
                Exp Year                    College/Univers Major or
GPA in major    Graduation   Degree Level   ity Name 3      Department   GPA in major




                 4 char
#, 3 decimal places                                                      #, 3 decimal places

                             BS
                             MS
                             PhD
                            Gender                              How did you
                            (participants                       hear about the
Exp Year                    live and work in What nationality   Engineering      Health Summer
Graduation   Degree Level   pairs)           will you hold?     World            Institute?




4 char

             BS             Male                                                 Department email
             MS             Female                                               Professor
             PhD                                                                 BMES conference
                                                                                 BMES chapter
                                                                                 EWH student chapter
                                                                                 Former participant
                                                                                 Online
                                                                                 Other
            Name of local                            Chapter events,
            University                Number of      e.g., repair    Are you
            sponsoring an             hours you have sessions (if    applying under Fellowship
            EWH             Chapter   attended EWH applicable)       a EWH Chapter program?




                                                                                    #

artment email

ES conference

H student chapter
mer participant
                How many                        How many                        How many
If yes, name of physics courses                 chemistry                       zoology/biology
sponsoring      with calculus   labs have you   college courses                 courses with
chapter.        and             had?            with labs       have you had?   labs




                               #, 2 char                       #, 2 char
                                               If your native
                                               language is not
                                               English,
                               Have you taken describe your       Have you
                Have you taken an              level of English   studied a
                a circuits     instrumentation reading, writing   foreign (non-
have you had?   course?        course?         and speaking       native)         language?




#, 2 char

                Yes             Yes                                               Yes
                No              No                                                No
If so, indicate
how many
semesters
(either in high
school or
college) you      have                                  Highest level
have studied      completed.   Language 1   Semesters   completed       Language 2




                                            #, 2 char

                               English                  High school     English
                               French                   AP              French
                               Spanish                  University      Spanish
                               Italian                                  Portugese
                               Portugese                                Swahili
                               Swahili                                  Other
                               Other
                                                                     Please list your
                                                                     extra-curricular
                                                                     activities,
                                                                     including any
                                                                     organizations in
            Highest level                            Highest level   which you are
Semesters   completed       Language 3   Semesters   completed       involved.




#, 2 char                                #, 2 char

            High school     English                  High school
            AP              French                   AP
            University      Spanish                  University
                            Portugese
                            Swahili
                            Other
Please list any                 All essays should
special                        be less than 250       Your entire essay
                               words for each of     may not show in
accomplishmen                  the essays. Your      the data array. To
ts, awards,                    answer will be        see you entire
honors or                      electronically        essay, place your          Do you have
leadership                     truncated at 250      cursor over the            previous
positions (club   IV. Essays   words.                cell.                 A)   experience
                                                               Describe any
                                          If you have          previous
                                          troubleshooting      experience in a
                                          experience           clinical setting
                                          outside of           (shadow days
                             outside of   class, please        in a hospital,
troubleshooting: in class?   class?       describe.       B)   clinic, veterinary




                 Yes         Yes
                 No          No
                                                             If so, list
     Describe an                                             countries to
     experience                                              which you have
     encountering                                            traveled.
     and overcoming      Have you ever
     a language          traveled outside States (or other
C)   barrier.       D)   of the United    home country)?




                                          Yes
                                          No
                           If so, list
                           countries where
                           you lived and          Describe your
                           number of              experiences
Have you ever              years you were         traveling alone,
lived outside of           there.                 foreign or
the United       States?                     E)   domestic.        F)




                Yes
                No
Working and                         Why do you                      Scan your
living in the                       want to                         transcripts
developing                          participate in                  (official or
world can be                        the Engineering                 unofficial) or
difficult.                          World Health                    report cards
Describe the                        Summer            V.            from all
most            experienced.   G)   Institute?        Transcripts   universities
                            Select a faculty   They must fill
                            member or          out the                          Please provide
                 VI.        other person       Recommender                      us with
Submit the                  who can            form found in                    information
scanned copies
                 Recommen   comment on         this packet and                  about your
with your        dation     your technical     email it to     by January 29,   recommender
application.     Letter     abilities.         dukesummerins 2010.              …
                         Telephone
First Name   Last Name   (work)      Email Address

				
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