Mount Sinai

School of Medicine

International Training

Program for Minority

Students

/
International Training
Program for Minority
Students
Department of
Preventive Medicine
1 Gustave Levy Place
—Box 1057
New York, NY 10029
Fax 212 996 0407
Application Instructions and Checklists
The information and checklist provided below are designed to assist you in applying to the International Training Program. Please do not hesitate to contact us if you have any questions about completing the application form.
Eligibility
Applicants must be:
Minorities underrepresented in the sciences as per the following NIH definition:
African Americans, Hispanic Americans, native Americans, Alaskan Natives, Native
Hawaiians and Pacific Islanders, and rural Appalachians.
The “Native Hawaiian or Other Pacific Islander” category is defined as “A person having
origins from any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.”
(The term “Native Hawaiian: does not include individuals who are native to the State of
Hawaii by virtue of being born there.) In addition to Native Hawaiians, Guamanians, and
Samoans, this category includes the following Pacific Islander groups:
Carolinian, Fijian, Kosraen, Melanesian, Northern Mariana Islander, Palauan, Papua New
Guinean, Ponapean (Pohnpelan), Polynesian, Solomon Islander, Tahitian, Tarawa Islander,
Tokelauan, Tongan, Trukese (Chuukese), and Yapese.
US citizens, non-citizen nationals or permanent residents
Enrolled in or recently graduated from BA, BS, MA, MPH, or other Master’s level programs and
Doctoral programs. A recent graduate is defined as one who obtained their degree no earlier
than May of last year
This program is for students interested in health sciences. Students in other fields will be
considered if they are willing to apply their skills to the health sciences. For example, a math
major may apply to participate in epidemiological or biostatistical research
Available for and willing to write research report and make an oral presentation of the
research report and make an oral presentation of the research performed
Application and Important Dates
Please fill out all parts of the application. Should questions not apply to you, please write “N/A” in the space provided.
The deadline for receipt of all application materials is January 15th. LATE APPLICATIONS WILL NOT BE ACCEPTED. Receipt of your application and other materials will be acknowledged via e-mail by March 1.
Please e-mail the completed application form, resume and statements to the email address provided below using International Training Program in the e-mail’s subject line. Please use this email address for any questions you may have. No telephone calls please.

Letters of recommendation must be signed and on letterhead. Letters of recommendation can be submitted via email, ground mail or fax. Emailed letters must be signed and on letterhead and can be sent as MSWord documents, jpeg or pdf files to the email address provided above.
School transcripts (from all schools attended) must be submitted via regular mail. Please use this address for sending letters of recommendation and school transcripts via ground mail:
International training Program for Minority Students
Department of Preventive Medicine
1 Gustave Levy Place--Box 1057
New York, NY 10029
Fax 212 996 0407
You must inform the Program of any change of mailing address, telephone number or e-mail address during the application process.
The Program Steering Committee will review all applications and notification of final decisions will be sent via email on or before March 31st.
International Exchange Program Checklist
Completed Application Form
Current Resume or Curriculum Vitae
Undergraduate and Graduate Transcripts
Personal Statement (2 page maximum): How will the Mount Sinai International Training
Program for Minority Students enhance your career? Include a description of your current
research interests and professional goals after completion of the program
Statement of Past Research Experience (1 page maximum): Please submit a brief description
of past research experience, including, the subject of the research project, dates conducted and
your role and duties
Statement of Past Travel Experience (1 page maximum): Please submit a brief description of
your past travel experience, including, place/s traveled, the nature of the visit/s, dates and
what you learned
Two professional letters of recommendation from individuals who know your work. Letters must
be signed and on letterhead. Please inform your letter writer that the Program may contact
him/her via email or telephone
OPTIONAL: There may be opportunities for original research under guidance and mentorship
of a scientist in one of the participating countries. If you might be interested in such an option,
please submit a 1 page description of original research you would like to conduct in host country
Atelephone interview may be conducted by the program director after the application is
received

Important Notice:

Summary of Important Dates
January 15th / Application Deadline. ALL materials must be received by this date. Late applications will not be accepted.
March 31st / Email notification of final decisions will be sent on or before this date
The program will acknowledge receipt of your application once it has been processed. It is your responsibility to submit a complete application (Please note checklist).
Do not contact project mentors unless you are instructed to do so by the program coordinators, failure to comply will lead to APPLICATION TERMINATION.

Mount Sinai

School of Medicine

International Training

Program for Minority

Students

/
International Training
Program for Minority
Students
Department of
Preventive Medicine
1 Gustave Levy Place
—Box 1057
New York, NY 10029
Fax 212 996 0407

1. Applicant Information

Full Legal Name as it appears on passport or birth certificate
(Use all capital letters for your FAMILY name) / Preferred Name / Gender
MF
Home Address--Street
City / State/ Province / Postal Code / Country
Postal Address (if different)---Street
City / State/Province / Postal Code / Country
Home Phone / Mobile Phone / Fax Number / E-mail
Date of Birth (M/D/Y) / Place of Birth (City/State/Province, Country) / Citizen of (Country)
Please check one of the following
US Citizen / Non-Citizen National / Permanent Resident

2. Education

Degrees (BA, MA, PhD etc.) / Area of Study (toxicology, epidemiology, etc.)
If a recent graduate, please provide month and year of graduation (M/D/Y)

3. Language

Native Language
Proficiency (indicate Poor, Fair, Good, or Fluent)
Non-native language(s) / Spoken / Written / Reading

4. Travel Experience

Location of Travel (Country) / Duration / Purpose

5. Courses Taught and Responsibilities

Title of Course Taught / Responsibilities

6. Conference Presentations

Name of Conference / Title of Work Presented At Conference

7. Research Interests

Please provide a brief list of your research areas of interest

8. Publications

If applicable, please list any publications that you have authorized

9. Research Skills

Please list your research skills (examples: PCR, Statistical Programs, Scientific Writing, Microscopy, Clinical Training, etc.)

Reference 1

Name and Title / Position
Institution / Department/ Division
Work Telephone / E-mail Address

Reference 2

Name and Title / Position
Institution / Department/ Division
Work Telephone / E-mail Address

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International Training Program for Minority Students