Deadline: Nov 15th
UNIVERSITY OF WATERLOO
APPLIED HEALTH SCIENCES
Application for Hallman Undergraduate Research Fellowship in Health Promotion
A. CONTACT INFORMATION
B. PROPOSAL DETAILS
1. Have you received funding from this fellowship before? Yes [ ] No [ ]
2. Short title of project (ensure that the description of the project makes it clear how it is related to health promotion to
a lay reader):
3. Expected start date of project:
4. Expected completion date of project:
5. Attach a description of duties and responsibilities
6. Provide name(s) of student to receive the award (if known)
C. FUNDING SUPPORT
Please note: additional applications in subsequent terms will not be accepted until the report has been submitted.
Your application will be funded for one term only.
1. Is this position a part-time research fellowship? Yes [ ] No [ ]
2. Is this position a full-time research fellowship Yes [ ] No [ ]
3. Is this position a co-op work term? Yes [ ] No [ ]
Please obtain the Undergraduate Research Internship (UW-URI) – Terms of Reference (also available from
Julie Cassaubon, ext 33923) and complete the required forms from Co-op.
4. Cost of Student Fellowship (amount requested from fund). See Julie Cassaubon to determine appropriate rate of
Obtain the payment guidelines from Julie Cassaubon (ext 33923) once you have received notice from the
Dean about your award.
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D. ATTACH DETAILED DESCRIPTION OF PROPOSAL
Describe your research project proposal in an attached document. Please include:
1. a short statement of the objectives
2. a general description of your research strategies and methodologies
3. experience and insights gained from the study
4. summarize how this educational opportunity benefited the student in terms of development and skills and
E. BUDGET: (Maximum $8,000)
______rate of pay (co-op scale) X _____ hrs/week X __weeks = _______ + 10% benefits = ______
F. BRIEF SUMMARY OF THE COMPLETED PROJECT
No later than two weeks after the student has completed the fellowship, please provide a 1-2 page brief summary
outlining how the work enhanced the student's learning experience while here at U of W and what new insights were
generated through the project in which the student was involved. This information will be relayed to the trustees of the
Hallman Foundation no later than 2 weeks after the end of the student’s fellowship period.
Please provide date of expected submission:_________________________
Signature, Dean, Applied Health Sciences Date