2018CityMatCHAT UNMC EXTERNSHIP APPLICATION

CityMatCH EXTERNSHIP OVERVIEW

CityMatCHat the University of Nebraska Medical Center (UNMC) is a national organization dedicated to promoting equity and improving the health of urban women, children, families and communities. As a membershiporganization, CityMatCHprovides education and training to over 160 health departments in large cities across the county. Our Strategic Work Planhas three core values—advancing health equity, promoting science and building public health leaders.

CityMatCHand UNMC are pleased to offer one externship opportunity to MSPH students at Meharry Medical College during the summer of 2018. This 10-week externship will take place in Omaha, NE where the student will have an unparalleled opportunity to develop knowledge and skills in maternal and child health. The extern will also enjoy a larger experience at UNMC by networking with professionals from the university’s College of Medicine and College of Public Health, along with other students completing summer internships/externships at UNMC.

Submit the following required application materials by February 9, 2018.

  • Application
  • A one page academic/research essay including long range goals, how you believe

this experience will assist you in your career, and any prior relevant experience (e.g.academic and/or field experiences)

  • Resume/curriculum vitae
  • Transcript(s) from colleges/universities you have attended (can be unofficial)
  • A minimum of two letters of recommendation – at least one professional and one

personal recommendation

Please submit all materials to Janet Rogers via email at OR

via mail to:

CityMatCH

University of Nebraska Medical Center

982170 Nebraska Medical Center

Omaha, NE 68198-2170

** Eligibility Requirements: Only U.S. citizens or students with permanent resident status may apply.**

APPLICATION FORM

Eligibility Requirements: Only U.S. citizens or students with permanent resident status may apply.

* Denotes items that must be included.

First Name*: ______

Last Name*: ______

E-mail Address*: ______(preferably not your school email)

Phone Number (include Area Code)*: ______

Current Address

Street: ______

______

City:______State: ______ZIP:______

Home Address

Street: ______

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City:______State: ______ZIP:______

Foreign Address

Street: ______

______

City:______Country: ______

Date of Birth (dd/mm/yyyy)*:

Racial/Ethnic Background (Optional):

Gender (Optional):

Additional Information (continued on next page)

Additional Information

Are you the first person in your family to attend college? ______

Do you come from a disadvantaged background?______

** Answer "Yes" if you come from an environment that has inhibited you from obtaining the knowledge, skill and abilities required to enroll in and graduate from a school; OR if you come from a family with an annual income below a level based on low-income thresholds according to family size published by the U.S. census.

If Yes, please elaborate: ______

______

______

______

______

______

Current GPA*: ______

Anticipated Graduation Date* (month/year): ______

Current Career goals: ______

______

Do you speak fluently any language other than English? ______

What language(s)?______