June 22 July 17, 2015 *These Dates Are Subject to Change

One Health Summer Research Program in Nicaragua Program Application

June 22 – July 17, 2015 *These dates are subject to change

Application Due Date: December 8, 2014

Graduate and Professional students at the College of Veterinary Medicine & Biomedical Sciences ,College of Medicine, and School of Rural Public Health at Texas A&M University are encouraged to apply for participation in the One Health Summer Research Program in Nicaragua with UC Davis. Contact Merrideth Holub at for questions.

·  E-mail your completed application to . One recommendation letter is required and can be sent from the faculty member or attached to the application.

Section I: Student Information

Name: ______

Expected Graduation Date: ______

Please Select One:

·  College of Veterinary Medicine & Biomedical Sciences

·  College of Medicine

·  School of Rural Public Health

·  College of Agriculture and Life Sciences

E-mail Address: ______

Current Address: ______

Daytime Telephone or Cell Number: ______

Academic Degrees: MS, PhD, MD, DVM, MPH, MHA, MSPH, Dr PH, Other

Date completed or anticipated: ______

Section II: Summary of Professional Scientific/Career Interests

Please keep your response to each question at 200 words or less.

·  Please describe the research that you are interested in and areas that are most interesting to you?

·  Please describe your educational and career goals?

·  Please explain how you would contribute to the diversity of the community of scholars in the Summer Research Program in Nicaragua?

·  Have you ever studied abroad and if so, where?

Section IV: Community or Researchers Expectations and Requirements

As a Summer Research Program participant, I understand my responsibilities are as follows (applies to TAMU and UCD students):

·  Meet all requirements necessary to remain enrolled

·  I fully understand that this is an international experience and must abide by all rules of the Study Abroad office including obtaining health insurance for the trip.

·  Obey all University Student Rules

o  TAMU - http://student-rules.tamu.edu/

o  UCD - http://sja.ucdavis.edu/scs.html

·  Conduct my personal behavior both on and off campus in a lawful manner with integrity and maturity

·  Participate and contribute to events planned for the Summer Research Program in Nicaragua

o  Attend designated Research Meeting times

o  Complete program assessments at the end of the program

·  Respect my fellow students and mentor members, staff and faculty members and others I meet during this experience

·  Collaborate with others as well as be proactive

·  Be actively involved in the summers activities, meetings, programs, events, etc.

I understand if I am accepted into the One Health Summer Research Program in Nicaragua, I must abide by all academic and social requirements of the program, as well as University policies and procedures. Failure to abide by these expectations and requirements in full or part may result in my removal from the Summer Research Program in Nicaragua. The submission of my application is an indication of my commitment to comply with all the stated program requirements.

Print Name: ______Date: ______

Signature: ______