THE 2019 CENTER FOR DIVERSITY IN PUBLIC HEALTH LEADERSHIP TRAINING

PROGRAMS ONLINE GUIDLINES

James A. Ferguson Emerging Infectious Diseases Research Initiatives for Student

Enhancement (RISE) Fellowship Program

Thank you for your interest in the James A. Ferguson Emerging Infectious Diseases-RISE
Fellowship Program.

THIS IS A SAMPLE APPLICATION PACKET

IMPORTANT: Please review the instructions before beginning the online
application. You MUST complete the entire application in one session (2 hours maximum
time allowed). This form will NOT save and allow you to return to complete. Once the
entire application is completed you can print it. Please be prepared to print your
application or change your print options and print to a PDF for your records.

Navigate the form (move from field to field) by hitting the tab button.

At the end of these instructions is the link to the Ferguson-RISE Fellowship Online Application.
Please note that all applications must be completed using the Center Program’s Online
Application. Applications submitted AFTER the deadline of January 31, 2019, 11:59PM
(Eastern Standard Time) will automatically be deleted from the system. All applications are
automatically dated and time stamped. If applying online poses a hardship, please contact our
office during business hours (9:00 AM to 5:00 PM Eastern Standard Time) before the closing
date for an alternate submission method (443-923-5901).

IMPORTANT: Be prepared to complete the application in one session (2 hours), as you

will NOT be able to save the form and return to complete later; you will be given the option
to PRINT the form once you hit SUBMIT. Have all of your documents and information
readily available and saved in the final formats. Many of the fields are required (REVIEW
APPLICATION CHECKLIST BEFORE BEGINNING THE APPLICATION).

The below instructions will help you complete the application. Before opening the application
link please review the instructions and the SAMPLE application at the end of the instructions in
detail.

The Program staff will not make any changes to submitted applications. Please review your
application carefully prior to submitting, especially the email addresses you enter for your
referees.

You will need to have the following information and electronic documents saved and accessible
on the computer you will be using to upload into the application or copy and paste into the
application.

Uploaded files should be in the following format and cannot exceed 25 MB (PDF format):
  Resume (PDF format): save file as: last name_first name_resume
 Unofficial Undergraduate Transcript (PDF format): save file as: last name_first
name_ugtranscript
 Unofficial Graduate Transcript (PDF format): save file as: last name_first
name_gradtranscript
Unofficial undergraduate transcript and graduate transcript includes your name
and the school name.

Have the following items completed and saved in a word document so you can cut and paste into
the online application:
1. The five (5) Short Answer Responses (maximum 250 words each response)
2. The Essay Questions #1 and #2 (both required—maximum 500 words each essay)
3. Name, email, and phone number of two faculty references (referees).
IMPORTANT NOTES: Please check and confirm you have entered the correct email
for your referees. A reference request will automatically be sent to the email address
entered on your application. Your referees may need to check their spam and/or junk
mail folder.

APPLICATION ACKNOWLEDGEMENT AND SUBMISSION:

Please type your full name in the field provided.
 Click Sign under the Signature Box.
 Use your cursor (or if you have a touch screen) sign your name in the box.
 Click Done, located below the signature box, when completed.

1) When you complete the application return to the top right column of the application
and click SUBMIT. If you forget to complete a section, hitting the SUBMIT button will
notify you what required items are missing in the Record Save Checklist (right column).

2) Submitting the Record may take a few seconds. Once completed you will be given the
option to Close or Print . Please be prepared to print your application or change
your print options and print to a PDF for your records.

3) Again, you will NOT be able to save the form AND return to complete later. THE
SUBMIT BUTTON SUBMITS COMPLETED APPLICATIONS TO THE
FERGUSON-RISE FELLOWSHIP PROGRAM OFFICE.

4) For your tracking, you will receive the following automatic emails (we recommend
you save these emails):
A) A confirmation receipt upon submission of your application
B) Notification when a referee submits a recommendation form to the
Ferguson-RISE Fellowship Program office.

This is NOT the Online Application—

This is a SAMPLE DOCUMENT
10/25/2018 Center for Diversity in Public Health Leadership Training Application

Center for Diversity in Public Health Leadership Training Application

Applicant Instructions

This application must be completed in a two-hour session. We suggest you thoroughly review the
SAMPLE APPLICATION (click HERE) and CHECKLIST (click HERE) before beginning to ensure
you have all information needed and documents you plan to upload readily accessible before starting.
You will not be able to begin, save and return to complete this application. The SUBMIT button on the
right top column will save and SUBMIT your application.

Please review your application carefully. The program willNOT

make any changes to your application.

Select Center Program

Name DOB For which center program are you Are you a U.S. Citizen, Permanent Resident, or U.S.
FERGUSON RISE TEST 10/25/2018 applying? National with necessary documentation?
Ferguson-RISE Fellowship Yes
Please confirm the information
entered is correct.
Yes

SAMPLE
Ferguson-RISE Applicant Eligibility Screen

1) Is your graduate GPA 3.0 or greater WITHOUT rounding and verified on your current unofficial transcript?
Yes
2) If a medical student, does your unofficial transcript/grades indicate that you are in good standing?
Yes
3) Is your graduation date in May or June of 2019?
No

Applicant Information

Date
10/25/2018
Email Address Email Address (personal email)
TEST@GMAIL.COM TEST@GMAIL.COM
Phone: Local Phone: Home
000-000-0000 000-000-0000
Phone: Cell Gender
000-000-0000 Other
Please specify other gender:
TEST
Race (Please select the best description of your race) Ethnicity (Hispanic or Latino)?
Other Race (please specify) Other
Please specify race details: Please specify other ethnicity:
TEST TEST
Primary language spoken at home Citizenship status
Other U.S. Citizen
Other primary language spoken at home:
TEST
First generational college? First generation U.S. Citizen

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10/25/2018 Center for Diversity in Public Health Leadership Training Application
Yes Are you first (1st) or second (2nd) generation U.S. Citizen or
Permanent Resident?

What is the country(ies) of your family’s origin?

TEST
Have you ever received free or reduced price lunch benefits? Pell grant eligible?
Yes Yes
I learned about the Center Program from: Do you know your FAFSA EFC (Expected Family Contribution) score?
Meeting Yes
FAFSA EFC (Expected Family Contribution) score:
20.00
If accepted, will you require any special accommodations?
Yes
Accommodations
Personal assistant
Other
If you require other/additional special accommodations, please
describe the type you will need, below.
TEST
Name of personal assistant, if applicable
TEST

Address Selection

Is your local address within the United States? Is your permanent address within the United States?
Yes No

SAMPLE
Local U.S Address

AFTER TYPING IN YOUR LOCAL ADDRESS, BE SURE TO CLICK "SELECT TO MAP" AS SEEN BELOW, TO
ENSURE YOUR ADDRESS IS SAVED.

Address City State County Zip

707 North Broadway Baltimore Maryland 21205

Non-U.S Address

Permanent Address-

Address- (permanent)
TEST
City- (permanent)
TEST
State (permanent)
TEST
County- (permanent)
TEST
Zip Code- (permanent)
TEST
Country (permanent)
TEST

College/University and Focus

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10/25/2018 Center for Diversity in Public Health Leadership Training Application
College/University
TEST
Minority Serving Institution
Other Minority-serving
What is your career focus?
Public Health Focus
What is your future career setting? (Select your top 1 or 2 settings)
Administrative Setting
Educational Setting (K-12)
Federal (FQHC)/State/Local Health Department Setting
Anticipated Graduation Date
10/25/2018
GPA Range: (MCH-LEARN/Ferguson-RISE)
3.0 to 3.4
Actual GPA: (MCH-LEARN/Ferguson-RISE)
3.20
Student Classification-Post-baccalaureate, i.e., your graduate year (Ferguson-RISE)
Other
Other Student Classification-Post-Baccalaureate-i.e graduation year (Ferguson-RISE)
TEST
Undergraduate Major (Ferguson-RISE)
Anthropology
Graduate/Professional Program (Ferguson-RISE)
Other Doctoral Degree
Select Doctoral Degree (Ferguson-RISE)
Other

SAMPLE
Other Doctoral Degree (Ferguson-RISE)
TEST
Please identify your area of concentration, select all that apply (Ferguson-RISE)
Biostatistics
Economics
Other
Other area of concentration (Ferguson-RISE)
TEST

Site Preference

Site Preferences (Ferguson-RISE)

CDC in Atlanta, GA

Housing

I need housing in Atlanta I need housing for the orientation in I will need parking information for the summer training site (parking
(Ferguson-RISE-CDC) Baltimore, MD (Ferguson-RISE) fees are not covered by the Program) (Ferguson-RISE)
Yes Yes Yes

Select your top 4 choices from these research areas (Ferguson-RISE-CDC)

Child Maltreatment Health Disparities (CDC) Public Health Education

1 2 3
Developmental Disabilities (CDC): Infectious Diseases Public Health Informatics
4
Emergency Preparedness Laboratory Science Public Health Policy

Epidemiology Mental Health Substance Abuse

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10/25/2018 Center for Diversity in Public Health Leadership Training Application

Short Answers

1. Describe your past community service, leadership, and/or research experiences. (250 word maximum)
TEST
2. How do you anticipate participating in this program/fellowship will help your future career goals? (250 word maximum)
TEST
3. List any achievements (i.e., honors or awards) (250 word maximum)
TEST

Ferguson-RISE Essays

Questions 1 and 2 are short answer (250 word max)

1. Describe how social determinants of health impact the prevention, treatment, and control of infectious or other diseases. (250 word
maximum)
TEST
2. How do you see the attainment of your career goals contributing to public health? (250 word maximum)
TEST

Questions 3 and 4 are essay questions (500 word max)

3. Which health challenge(s) are you most interested in learning more about? (500 word maximum)
TEST
4. Describe your ideal research project, include the public health challenge to be addressed, methods and expected results. (500 word

SAMPLE
maximum)
TEST

Curriculum Vitae or Resume and Undergraduate Transcript

PLEASE CHECK THE ACCURACY OF FILES UPLOADED.

Curriculum Vitae or Resume (PDF Format)

/document/download/filename/1540481354_41291_graphs.docx/

Below, attach your Unofficial University Undergraduate Transcript (PDF format).

Please ensure the transcript includes your name and the school name.

PLEASE NOTE: AN OFFICIAL UNDERGRADUATE TRANSCRIPT IS REQUIRED UPON ACCEPTANCE.

University Undergraduate Transcript

/document/download/filename/1540481354_41292_graphs.docx/

Graduate Transcript

Below, attach your Unofficial University Graduate Transcript (PDF format).

Please ensure the transcript includes your name and the school name.

PLEASE NOTE: AN OFFICIAL GRADUATE TRANSCRIPT IS REQUIRED UPON ACCEPTANCE.

University Graduate Transcript

/document/download/filename/1540481354_41293_graphs.docx/

Referee Information

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10/25/2018 Center for Diversity in Public Health Leadership Training Application

Two forms of recommendation from faculty at your previous or current university are required.
Upon submission (SAVE RECORD) of your application. An email will automatically be sent to
each referee with instructions on how to submit a recommendation on your behalf.

All recommendations must be completed using the electronic form provided to each referee.

Deadline for receipt of recommendations is January 31, 2019 11:59 PM EASTERN TIME.
Referee 1 Referee 1
TEST TEST Suffix
MS
Referee 1: Institution/Organization
TEST

PLEASE CHECK ACCURACY OF REFEREE EMAIL ADDRESS:

Referee 1: Email
TEST@gmail.com
Referee1 Phone #
000-000-0000
Email Trigger- Ref 1
Email Sent
From: apricotsoftwarealerts@gmail.com
To: TEST@gmail.com

Subject: Ferguson-RISE Fellowship Letter of Recommendation Request

Body: Dear TEST TEST, MS

SAMPLE
FERGUSON TEST, Applicant 2019 - Applicant ID: 396418 has requested a letter of recommendation from you for the
Ferguson-RISE Fellowship Program. The submission date for letters of recommendations is on or before January 31, 2019.

Please complete the recommendation form through the link provided:

https://ctk.apricot.info/6.5.1/auth/autologin/org_id/1048/hash/c95367e5810c7fb43f67b54f8de0163edd60c357

The link will only open in one of the following browsers: Google Chrome, Mozilla FireFox, or Safari (you may have to cut and
paste the link into your browser).

Please address the following characteristics in your letter of recommendation. The form provides a space to allow you to cut and paste
(Ctl + V) your letter of a maximum of 850 WORDS. Letters of recommendation must be completed in one on-line session. You
will NOT have the ability to save and return! Consider the following items in when constructing your comments:

• How long and in what capacity you have known the applicant

• Qualities the applicant possesses (i.e., intellectual ability, cooperation, integrity, initiative in learning, communication--written and oral)

• Applicant’s strengths and areas for improvement

• Overall strength of your endorsement (i.e., highest recommendation, highly recommended, recommend with confidence,
recommended with reservation, etc.)

Please enter the Applicant ID 396418 and the applicant's email address TEST@GMAIL.COM on the online form.

To submit the form, please click ‘Save Record’ (top right column on the page). You will not be able to save and return.

If you experience any problems completing the referee form simply copy and paste the form in an email, reference the Applicant Name
and ID in the subject line, and email to the appropriate program email address below:

PROGRAM EMAIL ADDRESS James A. Ferguson Emerging Infectious you,The Program

ThankDiseases Faculty
Fellowship (Ferguson Fellowship) Ferguson_LOR@

**This is an automatic message, please do not reply. https://apricot.socialsolutions.com/document/edit/id/396418

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10/25/2018 Center for Diversity in Public Health Leadership Training Application
Referee 2 Referee 2
TEST TEST Suffix
Ed.D.
Referee 2: Institution/Organization
TEST

PLEASE CHECK ACCURACY OF REFEREE EMAIL ADDRESS

Referee 2: Email
TEST@gmail.com
Referee 2 Phone #
000-000-0000
Email Trigger-Ref 2
Email Sent
From: apricotsoftwarealerts@gmail.com
To: TEST@gmail.com

Subject: Ferguson-RISE Fellowship Letter of Recommendation

Body: Dear TEST TEST Ed.D.

FERGUSON RISE TEST, Applicant ID 2019:396418 has requested a letter of recommendation from you for the
Ferguson-RISE Fellowship Program. The submission date for letters of recommendations is on or before January 31, 2019.

Please complete the recommendation form through the link provided:

https://ctk.apricot.info/6.5.1/auth/autologin/org_id/1048/hash/c95367e5810c7fb43f67b54f8de0163edd60c357

The link will only open in one of the following browsers: Google Chrome, Mozilla FireFox, or Safari (you may have to cut and
paste the link into your browser).

SAMPLE
Please address the following characteristics in your letter of recommendation. The form provides a space to allow you to cut and paste
(Ctl V) your letter of a maximum of 850 WORDS. Letters of recommendation must be completed in one on-line session.You will
NOT have the ability to save and return! Consider the following items in when constructing your comments:

• How long and in what capacity you have known the applicant

• Qualities the applicant possesses (i.e., intellectual ability, cooperation, integrity, initiative in learning, communication--written and oral)

• Applicant’s strengths and areas for improvement

• Overall strength of your endorsement (i.e., highest recommendation, highly recommended, recommend with confidence,
recommended with reservation, etc.)

Enter the Applicant ID: 396418 and the applicant's email addressTEST@GMAIL.COM on the online form.

To submit the form, please click ‘Save Record’ (top right column on the page). You will not be able to save and return.

If you experience any problems completing the referee form simply copy and paste the form in an email, reference the Applicant Name
and ID in the subject line, and email to the appropriate program email address below:

PROGRAM EMAIL ADDRESS James A. Ferguson Emerging Infectious you,The Program

ThankDiseases Faculty
Fellowship (Ferguson Fellowship) Ferguson_LOR@

**This is an automatic message, please do not reply. https://apricot.socialsolutions.com/document/edit/id/396418

Emergency Contact

Emergency Contact Name

TEST
Phone: Emergency Contact
000-000-0000
Address Postal Code
707 North Broadway Baltimore Maryland 21205

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10/25/2018 Center for Diversity in Public Health Leadership Training Application

Consent and Application Acknowledgement

I agree to be contacted to help evaluate the need for summer public health leadership programs. Participation in an end of summer evaluation
will include a drawing for a gift card.
Yes

By signing below you understand that you are waiving your right to request that the Center for Diversity in Public Health Leadership
Training send you recommendations that your referees have submitted on your behalf.

*Please type your full name and provide signature in the box using the cursor. By doing so you acknowledge that the information contained in
this application is true and accurate to the best of your knowledge and that information may be summarized and shared with the Federal
Funding Agency.
Signature

Name Witnessed By
TEST Megan Reed on 10/25/2018 11:28

Carefully review your application for accuracy prior to submitting your application. The Program Office will not
make revisions to your application once it is submitted.

SAMPLE
To SUBMIT your application, click 'SUBMIT' (top right column).

If you DO NOT receive an Email confirmation following the submission of your application, please contact:

Ferguson_Fellowship@kennedykrieger.org

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COMPLETING ONLINE APPLICATION CHECKLIST:
 Carefully reviewed the sample application
 Created Word document so you can cut and paste into the online application
a. The five (5) Short Answer Responses (maximum 250 words each response)
b. Two required Essay Questions (maximum 500 words each essay)
 Confirmed the contact details of your two faculty references (referees) are accurate
a. Name, email, and phone number of two faculty references (referees)
b. A reference request will automatically be sent to the email address entered on
your application. Your referees may need to check their spam and/or junk mail
folder.
 Created resume/CV PDF
a. File does not exceed 25MB
b. Saved file as: last name_first name_resume
 Created undergraduate transcript and graduate transcript PDF
a. File does not exceed 25MB
b. Unofficial undergraduate transcript and graduate transcript includes your name
and the school name.
c. Undergraduate transcript
 Saved file as: last name_first name_ugtranscript
d. Graduate transcript
 Saved file as: last name_first name_gradtranscript

APPLICATION LINK:
If you are ready to complete the Ferguson-RISE Fellowship Application PLEASE CLICK
HERE TO BEGIN. (Right click on the TEXT LINK and select Copy Hyperlink, then paste
URL into one of the following Browsers: FireFox or Google CHROME).

You MUST complete the entire application in one session (2 hours maximum time allowed).
This form will NOT save and allow you to return to complete. Please review the
accuracy of completed application prior to submission. The Program staff
will not make any changes to submitted applications.

Once the entire application is completed you can print it. Please be prepared to print your
application or change your print options and print to a PDF for your records.

Applications submitted AFTER the deadline of January 31, 2019, 11:59PM (Eastern Standard
Time) will automatically be deleted from the system. All applications are automatically dated
and time stamped. If applying online poses a hardship, please contact our office during business
hours (9:00 AM to 5:00 PM Eastern Standard Time) before the closing date for an alternate
submission method (443-923-5901).