{"id":5100,"date":"2025-09-08T15:14:03","date_gmt":"2025-09-08T20:14:03","guid":{"rendered":"https:\/\/monsoon.dev\/projects\/schweitzer\/?page_id=5100"},"modified":"2025-09-25T11:50:21","modified_gmt":"2025-09-25T16:50:21","slug":"fellow-application-form","status":"publish","type":"page","link":"https:\/\/monsoon.dev\/projects\/schweitzer\/fellow-application-form\/","title":{"rendered":"Fellow Application Form"},"content":{"rendered":"<p><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:14vh;--awb-padding-right:0px;--awb-padding-bottom:40px;--awb-padding-left:0px;--awb-padding-top-medium:14vh;--awb-padding-right-medium:5vw;--awb-padding-bottom-medium:40px;--awb-padding-left-medium:5vw;--awb-padding-top-small:10vh;--awb-padding-right-small:5vw;--awb-padding-bottom-small:5vw;--awb-padding-left-small:5vw;--awb-margin-top-small:0px;--awb-margin-bottom-small:0px;--awb-background-color:var(--awb-color2);--awb-background-image:linear-gradient(180deg, hsla(var(--awb-color2-h),var(--awb-color2-s),calc(var(--awb-color2-l) - 5%),var(--awb-color2-a)) 0%,var(--awb-color1) 90%);--awb-flex-wrap:wrap;\" ><div class=\"awb-background-pattern\" style=\"background-image:  url(data:image\/svg+xml;utf8,%3Csvg%20width%3D%22120%22%20height%3D%22120%22%20fill%3D%22none%22%20xmlns%3D%22http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%22%3E%3Cpath%20fill-rule%3D%22evenodd%22%20clip-rule%3D%22evenodd%22%20d%3D%22M120%200H0v120h120V0zm0%2030c0%2016.569-13.431%2030-30%2030-16.569%200-30-13.431-30-30C60%2013.431%2073.431%200%2090%200c16.569%200%2030%2013.431%2030%2030zm0%2060c0%2016.569-13.431%2030-30%2030-16.564%200-29.993-13.425-30-29.987C59.993%20106.575%2046.564%20120%2030%20120c-16.569%200-30-13.431-30-30%200-16.569%2013.431-30%2030-30%2016.564%200%2029.993%2013.425%2030%2029.987C60.007%2073.425%2073.436%2060%2090%2060c16.569%200%2030%2013.431%2030%2030zM0%2030C0%2013.431%2013.431%200%2030%200c16.569%200%2030%2013.431%2030%2030%200%2016.569-13.431%2030-30%2030C13.431%2060%200%2046.569%200%2030zm90%2028.512c-15.747%200-28.512-12.765-28.512-28.512S74.253%201.488%2090%201.488%20118.512%2014.253%20118.512%2030%20105.747%2058.512%2090%2058.512zM1.488%2030c0%2015.747%2012.765%2028.512%2028.512%2028.512S58.512%2045.747%2058.512%2030%2045.747%201.488%2030%201.488%201.488%2014.253%201.488%2030zm9.981%200c0%2010.234%208.297%2018.53%2018.531%2018.53%2010.234%200%2018.53-8.296%2018.53-18.53%200-10.234-8.296-18.53-18.53-18.53-10.234%200-18.53%208.296-18.53%2018.53zM30%2050c-11.046%200-20-8.954-20-20s8.954-20%2020-20%2020%208.954%2020%2020-8.954%2020-20%2020zm0%2068.512c-15.747%200-28.512-12.765-28.512-28.512S14.253%2061.488%2030%2061.488%2058.512%2074.253%2058.512%2090%2045.747%20118.512%2030%20118.512zM11.47%2090c0%2010.234%208.296%2018.531%2018.53%2018.531%2010.234%200%2018.53-8.297%2018.53-18.531%200-10.234-8.296-18.53-18.53-18.53-10.234%200-18.53%208.296-18.53%2018.53zM30%20110c-11.046%200-20-8.954-20-20s8.954-20%2020-20%2020%208.954%2020%2020-8.954%2020-20%2020zm41.47-80c0%2010.234%208.296%2018.53%2018.53%2018.53%2010.234%200%2018.531-8.296%2018.531-18.53%200-10.234-8.297-18.53-18.531-18.53-10.234%200-18.53%208.296-18.53%2018.53zM90%2050c-11.046%200-20-8.954-20-20s8.954-20%2020-20%2020%208.954%2020%2020-8.954%2020-20%2020zm0%2068.512c-15.747%200-28.512-12.765-28.512-28.512S74.253%2061.488%2090%2061.488%20118.512%2074.253%20118.512%2090%20105.747%20118.512%2090%20118.512zM71.47%2090c0%2010.234%208.296%2018.531%2018.53%2018.531%2010.234%200%2018.531-8.297%2018.531-18.531%200-10.234-8.297-18.53-18.531-18.53-10.234%200-18.53%208.296-18.53%2018.53zM90%20110c-11.046%200-20-8.954-20-20s8.954-20%2020-20%2020%208.954%2020%2020-8.954%2020-20%2020z%22%20fill%3D%22rgba%28255%2C255%2C255%2C1%29%22%2F%3E%3C%2Fsvg%3E);opacity: 1 ;background-size:200px;mix-blend-mode:normal;\"><\/div><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"max-width:calc( 1200px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_2 1_2 fusion-flex-column fusion-flex-align-self-flex-start\" style=\"--awb-padding-bottom-small:80px;--awb-bg-size:cover;--awb-border-color:var(--awb-color4);--awb-border-top:0px;--awb-border-right:0px;--awb-border-bottom:0px;--awb-border-left:0px;--awb-border-style:solid;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:4vw;--awb-margin-bottom-large:0px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:4vw;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-1 fusion-sep-none fusion-title-text fusion-title-size-one\" style=\"--awb-text-color:var(--awb-color7);--awb-margin-top:0px;--awb-margin-bottom:0px;--awb-margin-top-small:0px;--awb-margin-bottom-small:0px;--awb-font-size:72px;\"><h1 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;font-size:1em;--fontSize:72;line-height:1;\">Application Opening<\/h1><\/div><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-highlight fusion-animate-once fusion-highlight-underline_zigzag fusion-title-size-one\" style=\"--awb-text-color:var(--awb-color7);--awb-highlight-color:var(--awb-color4);--awb-margin-top:0px;--awb-margin-bottom:10px;--awb-margin-top-small:0px;--awb-margin-bottom-small:0px;--awb-font-size:72px;\" data-highlight=\"underline_zigzag\"><h1 class=\"fusion-title-heading title-heading-left fusion-responsive-typography-calculated\" style=\"margin:0;font-size:1em;--fontSize:72;line-height:1.25;\"><span class=\"fusion-highlighted-text-prefix\"><\/span> <span class=\"fusion-highlighted-text-wrapper\"><span class=\"fusion-highlighted-text\" style=\"color:var(--awb-color5);--fontSize:84;font-size:84px;\">SOON!<\/span><svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 500 150\" preserveAspectRatio=\"none\"><path d=\"M6.1,133.6c0,0,173.4-20.6,328.3-14.5c154.8,6.1,162.2,8.7,162.2,8.7s-262.6-4.9-339.2,13.9 c0,0,113.8-6.1,162.9,6.9\"><\/path><\/svg><\/span> <span class=\"fusion-highlighted-text-postfix\"><\/span><\/h1><\/div><\/div><\/div><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-1 fusion_builder_column_1_2 1_2 fusion-flex-column fusion-flex-align-self-flex-start\" style=\"--awb-padding-bottom-small:0px;--awb-bg-size:cover;--awb-border-color:var(--awb-color4);--awb-border-top:0px;--awb-border-right:0px;--awb-border-bottom:0px;--awb-border-left:0px;--awb-border-style:solid;--awb-width-large:50%;--awb-margin-top-large:0px;--awb-spacing-right-large:0px;--awb-margin-bottom-large:0px;--awb-spacing-left-large:0px;--awb-width-medium:50%;--awb-order-medium:0;--awb-spacing-right-medium:0px;--awb-spacing-left-medium:0px;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:0px;--awb-spacing-left-small:0px;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1 sm-text-align-left fusion-text-no-margin\" style=\"--awb-content-alignment:justify;--awb-line-height:1.25em;--awb-text-color:var(--awb-color7);--awb-margin-top:0px;--awb-margin-bottom:0px;\"><p>The 2026-2027 application will open soon! Please use this application if you are an undergraduate or graduate applicant. The Scholar application is only for our small cohort of TCH Pediatric residents and fellows.<\/p>\n<p>Please note that there is a word limit for each question, and going over it will result in deductions by reviewers. You can find the rubric that is used <a href=\"https:\/\/monsoon.dev\/projects\/schweitzer\/wp-content\/uploads\/2025\/09\/ASFHG-2025-2026-Rubric.pdf\" target=\"_blank\" rel=\"noopener\">here<\/a>.<\/p>\n<p>The application deadline is February 2nd, 2026. You will be contacted about whether you&#8217;ve been selected to interview by late February. Decisions will be emailed to the applicants in late March or April 2026.<\/p>\n<p>Questions inspired by the Cheng Evaluation Guidelines from the <a href=\"https:\/\/sici.hks.harvard.edu\/\" target=\"_blank\" rel=\"noopener\"><i>Social Innovation and Change Initiative at Harvard Kennedy School<\/i><\/a>.<\/p>\n<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-2 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-padding-top:0px;--awb-padding-right:0px;--awb-padding-bottom:14vh;--awb-padding-left:0px;--awb-padding-top-medium:20px;--awb-padding-right-medium:5vw;--awb-padding-bottom-medium:10vh;--awb-padding-left-medium:5vw;--awb-padding-top-small:0px;--awb-padding-right-small:5vw;--awb-padding-bottom-small:10vh;--awb-padding-left-small:5vw;--awb-background-color:var(--awb-color1);--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-justify-content-center fusion-flex-content-wrap\" style=\"max-width:calc( 1200px + 0px );margin-left: calc(-0px \/ 2 );margin-right: calc(-0px \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-2 fusion_builder_column_1_1 1_1 fusion-flex-column fusion-flex-align-self-flex-start\" 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_5' style='display:none'><div id='gf_5' class='gform_anchor' tabindex='-1'><\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_5' id='gform_5'  action='\/projects\/schweitzer\/wp-json\/wp\/v2\/pages\/5100#gf_5' data-formid='5' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_5' class='gform_fields top_label form_sublabel_above description_above validation_below'><div id=\"field_5_6\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Contact Information<\/h3><\/div><fieldset id=\"field_5_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield--width-full gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_5_1'>\n                            \n                            <span id='input_5_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_5_1_3' value=''   aria-required='true'   placeholder='John' autocomplete=\"given-name\" \/>\n                                                    <label for='input_5_1_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_5_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_5_1_6' value=''   aria-required='true'   placeholder='Smith' autocomplete=\"family-name\" \/>\n                                                    <label for='input_5_1_6' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_5_2\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_2'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_2' id='input_5_2' type='email' value='' class='large'   placeholder='your@email.com' aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_5_3\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_above gfield--no-description field_description_above hidden_label field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_3'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_5_3' type='tel' value='' class='large'  placeholder='Phone Number*' aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_5_4\" class=\"gfield gfield--type-address gfield--input-type-address field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Address<\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_5_4' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_5_4_1_container' >\n                                        <input type='text' name='input_4.1' id='input_5_4_1' value=''   placeholder='1234 5th Street' aria-required='false'    \/>\n                                        <label for='input_5_4_1' id='input_5_4_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_5_4_2_container' >\n                                        <input type='text' name='input_4.2' id='input_5_4_2' value=''   placeholder='Suite 6'  aria-required='false'   \/>\n                                        <label for='input_5_4_2' id='input_5_4_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_5_4_3_container' >\n                                    <input type='text' name='input_4.3' id='input_5_4_3' value=''   placeholder='Houston' aria-required='false'    \/>\n                                    <label for='input_5_4_3' id='input_5_4_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_5_4_4_container' >\n                                        <select name='input_4.4' id='input_5_4_4'     aria-required='false'    ><option value='' selected='selected'>Texas<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_5_4_4' id='input_5_4_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_5_4_5_container' >\n                                    <input type='text' name='input_4.5' id='input_5_4_5' value=''   placeholder='77030' aria-required='false'    \/>\n                                    <label for='input_5_4_5' id='input_5_4_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_4.6' id='input_5_4_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_5_7\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Education<\/h3><\/div><fieldset id=\"field_5_45\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-horizontal\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Will you be enrolled in a degree-granting program through April 2027? *<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_45'>\n\t\t\t<div class='gchoice gchoice_5_45_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='Yes'  id='choice_5_45_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_45_0' id='label_5_45_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_45_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_45' type='radio' value='No'  id='choice_5_45_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_45_1' id='label_5_45_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_9\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_9'>What year in your degree program will you be during the 2026-2027 academic year?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_9' id='input_5_9' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='First' >First<\/option><option value='Second' >Second<\/option><option value='Third' >Third<\/option><option value='Fourth' >Fourth<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_5_11\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_11'>Expected graduation date (if you are planning to graduate in December 2026, please indicate that here).<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_11' id='input_5_11' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_5_11_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_5_11_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_5_11' class='gform_hidden' value='https:\/\/monsoon.dev\/projects\/schweitzer\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/div><div id=\"field_5_12\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_12'>For joint applications, please list your project partner&#039;s full name:<\/label><div class='ginput_container ginput_container_text'><input name='input_12' id='input_5_12' type='text' value='' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_13\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_13'>What school do you attend?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_13' id='input_5_13' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Baylor College of Medicine' >Baylor College of Medicine<\/option><option value='PVAMU' >PVAMU<\/option><option value='Texas A&amp;M School of Public Health' >Texas A&amp;M School of Public Health<\/option><option value='Texas Southern University' >Texas Southern University<\/option><option value='Texas Women&#039;s University' >Texas Women&#039;s University<\/option><option value='Univ. of Houston - Honors College' >Univ. of Houston - Honors College<\/option><option value='Univ. of Houston - College of Medicine' >Univ. of Houston - College of Medicine<\/option><option value='Univ. of Houston - College of Nursing' >Univ. of Houston - College of Nursing<\/option><option value='Univ. of Houston - College of Pharmacy' >Univ. of Houston - College of Pharmacy<\/option><option value='Texas A&amp;M EnMed Program' >Texas A&amp;M EnMed Program<\/option><option value='UTHealth - McGovern Medical School' >UTHealth - McGovern Medical School<\/option><option value='UTHealth - School of Dentistry' >UTHealth - School of Dentistry<\/option><option value='UTHealth - School of Public Health' >UTHealth - School of Public Health<\/option><option value='UTMB - School of Public and Population Health' >UTMB - School of Public and Population Health<\/option><option value='UTMB - School of Medicine' >UTMB - School of Medicine<\/option><option value='UTMB - School of Health Professions' >UTMB - School of Health Professions<\/option><option value='Other' >Other<\/option><\/select><\/div><\/div><div id=\"field_5_14\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_14'>What is the name of your college?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_5_14' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_15\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_15'>What is your Discipline of Study?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_5_15' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_16\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-half gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_16'>What type of Fellowship are you applying for?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_16' id='input_5_16' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Junior Fellow (Undergraduate)' >Junior Fellow (Undergraduate)<\/option><option value='Senior Fellow (Graduate Student)' >Senior Fellow (Graduate Student)<\/option><option value='Scholar (Physician Resident \/ Fellow)' >Scholar (Physician Resident \/ Fellow)<\/option><\/select><\/div><\/div><fieldset id=\"field_5_46\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-horizontal\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >IRBs are strongly discouraged in the year of your Fellowship unless there is a valid explanation under unique circumstances. Do you plan on applying for an IRB at any point in the Fellowship year(i.e: starting a new IRB, amending a current IRB, applying for a waiver)? If yes, please explain.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_46'>\n\t\t\t<div class='gchoice gchoice_5_46_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Yes'  id='choice_5_46_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_46_0' id='label_5_46_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_5_46_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='No'  id='choice_5_46_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_46_1' id='label_5_46_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_18\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_18'>Please provide an explanation in the field below.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_18' id='input_5_18' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_19\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_19'>Please indicate any times you anticipate being out of the area and\/or unable to participate in Fellowship activities. This includes extensive time out of the country, away rotations and other significant time commitments.<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_19' id='input_5_19' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_20\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Project Information<\/h3><\/div><div id=\"field_5_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_21'>Proposed community agency\/agencies (if a community agency has not yet been identified, please type TBD).<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_5_21' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_5_22\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_22'>1. Please describe the social problem (ecosystem and root causes) and target population you wish to impact with your proposed community service project, including demographic information.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_22'>This answer should be the same for all project partners. (Word limit:150)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_22' id='input_5_22' class='textarea medium'  aria-describedby=\"gfield_description_5_22\" maxlength='750'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_30\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_30'>Citations (type N\/A if not applicable); this is not included in the word count.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_30' id='input_5_30' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_25\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_25'>2. Describe the community need for your project and how your project will address an unmet health need.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_25'>This answer should be the same for all project partners. (Word limit: 150)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_5_25' class='textarea medium'  aria-describedby=\"gfield_description_5_25\" maxlength='750'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_31\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_31'>Citations (type N\/A if not applicable); this is not included in the word count.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_31' id='input_5_31' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_24\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_24'>3. Describe a future where the problem your proposed project addresses is absent.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_24'>This answer should be the same for all project partners. (Word limit: 150)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_24' id='input_5_24' class='textarea medium'  aria-describedby=\"gfield_description_5_24\" maxlength='750'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_23\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_23'>4. Please describe your proposed community service project, including project goals and the actions you will take to meet these goals, and anticipated outputs.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_23'>Applicants applying as a pair should discuss the role of each partner. This answer should be the same for all project partners. (Word limit: 200)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_23' id='input_5_23' class='textarea medium'  aria-describedby=\"gfield_description_5_23\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_26\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_26'>5. How do you hope these actions will drive social impact for the target population identified in the first question?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_26'>This answer should be the same for all project partners. (Word limit: 150)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_26' id='input_5_26' class='textarea medium'  aria-describedby=\"gfield_description_5_26\" maxlength='750'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_32\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_32'>Citations (type N\/A if not applicable); this is not included in the word count.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_32' id='input_5_32' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_29\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_29'>6. Describe the avenues you will explore to sustain the project beyond your time as a Fellow.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_29'>Please note that while it is helpful, simply having a new Fellow take over is not a comprehensive sustainability plan. This answer should be the same for all project partners. (Word limit: 100)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_29' id='input_5_29' class='textarea medium'  aria-describedby=\"gfield_description_5_29\" maxlength='500'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_28\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_28'>7. How will you evaluate the project to determine whether your goals were met? How will you know if your project has been successful or verify your results?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_28'> This answer should be the same for all project partners. (Word limit: 150)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_28' id='input_5_28' class='textarea medium'  aria-describedby=\"gfield_description_5_28\" maxlength='750'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_27\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_27'>8. How will your proposed project innovate current efforts that address these social problems?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_27'> Applicants proposing to sustain an existing project supported by the Schweitzer Fellowship should explain why they are choosing to continue this particular project and the ways in which the project will be expanded or improved. This answer should be the same for all project partners. (Word limit: 150)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_27' id='input_5_27' class='textarea medium'  aria-describedby=\"gfield_description_5_27\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_33\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_33'>Citations (type N\/A if not applicable); this is not included in the word count.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_33' id='input_5_33' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_34\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Personal &amp; Professional Information<\/h3><\/div><div id=\"field_5_35\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_35'>9. Considering that there are many different types of community service projects a Fellow could design, what inspired you to develop your particular project idea (including your proximity to the community\/problem of interest)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_35'>This answer should be DIFFERENT for all project partners. (Word limit: 150)<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_35' id='input_5_35' class='textarea medium'  aria-describedby=\"gfield_description_5_35\" maxlength='750'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_36\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_36'>10. Personal Statements.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_36'>Please discuss the following. This answer should be different for all project partners. (Word limit: 400).\n\n1. What is your motivation for applying to the Albert Schweitzer Fellowship? \n\n2. What skills and experiences you will bring to the Fellowship?\n\n3. Are there any unique, personally important, and\/or challenging factors in your background, and how they have influenced your goals and preparation for your career?<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_36' id='input_5_36' class='textarea medium'  aria-describedby=\"gfield_description_5_36\" maxlength='2800'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_37\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_37'>Please list your proposed Academic Mentor. Include a phone number (if possible) and email address.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_5_37' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_38\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_38'>Please list your proposed Site Mentor. Include an phone number (if possible) and email address.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_38' id='input_5_38' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_39\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_39'>Please list your proposed Site Mentor. Include an phone number (if possible) and email address.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_39' id='input_5_39' class='textarea small'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_5_40\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_40'>Please select the Track that best fits your proposed project. If your project doesn&#039;t fit any of these, select &quot;Open Track&quot;.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_40' id='input_5_40' class='large gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Select One of the Following Options...' >Select One of the Following Options...<\/option><option value='Homeless Health' >Homeless Health<\/option><option value='Refugee &amp; Immigrant Health' >Refugee &amp; Immigrant Health<\/option><option value='HIV \/ Sexual Health \/ Human Trafficking' >HIV \/ Sexual Health \/ Human Trafficking<\/option><option value='Oral Health' >Oral Health<\/option><option value='Mental Health' >Mental Health<\/option><option value='Nutrition \/ Health Eating \/ Exercise' >Nutrition \/ Health Eating \/ Exercise<\/option><option value='LGBTQIA+ Health' >LGBTQIA+ Health<\/option><option value='Special Needs Health' >Special Needs Health<\/option><option value='Aging &amp; Elderly Health' >Aging &amp; Elderly Health<\/option><option value='Environmental Health' >Environmental Health<\/option><option value='Individuals with Disabilities' >Individuals with Disabilities<\/option><option value='Vision Health' >Vision Health<\/option><option value='Women&#039;s Health' >Women&#039;s Health<\/option><option value='Children&#039;s Health' >Children&#039;s Health<\/option><option value='Open Track' >Open Track<\/option><\/select><\/div><\/div><div id=\"field_5_41\" class=\"gfield gfield--type-fileupload gfield--input-type-fileupload gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='gform_browse_button_5_41'>Upload your resume and a head shot of yourself here.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_5_41'>Please be mindful when submitting your headshots. Try to ensure that it is not a selfie, it is taken with good lighting, you're wearing what you would wear to an interview, and the background is simple.<\/div><div class='ginput_container ginput_container_fileupload'><div id='gform_multifile_upload_5_41' data-settings='{&quot;runtimes&quot;:&quot;html5,flash,html4&quot;,&quot;browse_button&quot;:&quot;gform_browse_button_5_41&quot;,&quot;container&quot;:&quot;gform_multifile_upload_5_41&quot;,&quot;drop_element&quot;:&quot;gform_drag_drop_area_5_41&quot;,&quot;filelist&quot;:&quot;gform_preview_5_41&quot;,&quot;unique_names&quot;:true,&quot;file_data_name&quot;:&quot;file&quot;,&quot;url&quot;:&quot;https:\\\/\\\/monsoon.dev\\\/projects\\\/schweitzer\\\/?gf_page=4daa6d0f6859a2f&quot;,&quot;flash_swf_url&quot;:&quot;https:\\\/\\\/monsoon.dev\\\/projects\\\/schweitzer\\\/wp-includes\\\/js\\\/plupload\\\/plupload.flash.swf&quot;,&quot;silverlight_xap_url&quot;:&quot;https:\\\/\\\/monsoon.dev\\\/projects\\\/schweitzer\\\/wp-includes\\\/js\\\/plupload\\\/plupload.silverlight.xap&quot;,&quot;filters&quot;:{&quot;mime_types&quot;:[{&quot;title&quot;:&quot;Allowed Files&quot;,&quot;extensions&quot;:&quot;*&quot;}],&quot;max_file_size&quot;:&quot;31457280b&quot;},&quot;multipart&quot;:true,&quot;urlstream_upload&quot;:false,&quot;multipart_params&quot;:{&quot;form_id&quot;:5,&quot;field_id&quot;:41},&quot;gf_vars&quot;:{&quot;max_files&quot;:0,&quot;message_id&quot;:&quot;gform_multifile_messages_5_41&quot;,&quot;disallowed_extensions&quot;:[&quot;php&quot;,&quot;asp&quot;,&quot;aspx&quot;,&quot;cmd&quot;,&quot;csh&quot;,&quot;bat&quot;,&quot;html&quot;,&quot;htm&quot;,&quot;hta&quot;,&quot;jar&quot;,&quot;exe&quot;,&quot;com&quot;,&quot;js&quot;,&quot;lnk&quot;,&quot;htaccess&quot;,&quot;phtml&quot;,&quot;ps1&quot;,&quot;ps2&quot;,&quot;php3&quot;,&quot;php4&quot;,&quot;php5&quot;,&quot;php6&quot;,&quot;py&quot;,&quot;rb&quot;,&quot;tmp&quot;]}}' class='gform_fileupload_multifile'>\n\t\t\t\t\t\t\t\t\t\t<div id='gform_drag_drop_area_5_41' class='gform_drop_area gform-theme-field-control'>\n\t\t\t\t\t\t\t\t\t\t\t<span class='gform_drop_instructions'>Drop files here or <\/span>\n\t\t\t\t\t\t\t\t\t\t\t<button type='button' id='gform_browse_button_5_41' class='button gform_button_select_files gform-theme-button gform-theme-button--control' aria-describedby=\"gfield_upload_rules_5_41 gfield_description_5_41\"  >Select files<\/button>\n\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_5_41'>Max. file size: 30 MB.<\/span><ul class='validation_message--hidden-on-empty gform-ul-reset' id='gform_multifile_messages_5_41'><\/ul> <div id='gform_preview_5_41' class='ginput_preview_list'><\/div><\/div><\/div><fieldset id=\"field_5_42\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >If selected to serve as a Schweitzer Fellow, I will commit to the following:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_5_42'>(Please select all boxes to indicate that you agree.)<\/div><div class='ginput_container ginput_container_checkbox'><span class='gfield_choice_limit_message gfield_description' id='gfield_choice_limit_message_5_42'>Select at least <strong>6<\/strong> choices.<\/span><div class='gfield_checkbox ' id='input_5_42'><div class='gchoice gchoice_5_42_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.1' type='checkbox'  value='Perform at least 200 hours of service if applying as a Fellow, and 100 hours if applying as a Junior Fellow'  id='choice_5_42_1'   aria-describedby=\"gfield_choice_limit_message_5_42 gfield_description_5_42\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_5_42_1' id='label_5_42_1' class='gform-field-label gform-field-label--type-inline'>Perform at least 200 hours of service if applying as a Fellow, and 100 hours if applying as a Junior Fellow<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_42_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.2' type='checkbox'  value='Attend an all-day orientation on Saturday, April 11th, 2026'  id='choice_5_42_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_42_2' id='label_5_42_2' class='gform-field-label gform-field-label--type-inline'>Attend an all-day orientation on Saturday, April 11th, 2026<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_42_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.3' type='checkbox'  value='Attend ASF&#039;S Virtual National Convening in May of 2026 (Exact Date TBD)'  id='choice_5_42_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_42_3' id='label_5_42_3' class='gform-field-label gform-field-label--type-inline'>Attend ASF'S Virtual National Convening in May of 2026 (Exact Date TBD)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_42_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.4' type='checkbox'  value='Attend all monthly meetings in person in Houston or in my designated Sattelite site if I am in College Station, Austin, or DFW'  id='choice_5_42_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_42_4' id='label_5_42_4' class='gform-field-label gform-field-label--type-inline'>Attend all monthly meetings in person in Houston or in my designated Sattelite site if I am in College Station, Austin, or DFW<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_42_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.5' type='checkbox'  value='Hold one information session at your school in the Fall of 2026'  id='choice_5_42_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_42_5' id='label_5_42_5' class='gform-field-label gform-field-label--type-inline'>Hold one information session at your school in the Fall of 2026<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_42_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_42.6' type='checkbox'  value='Present a poster and oral project summary at the Evening of Difference in May 2027'  id='choice_5_42_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_42_6' id='label_5_42_6' class='gform-field-label gform-field-label--type-inline'>Present a poster and oral project summary at the Evening of Difference in May 2027<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_5_43\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >How did you first hear about the Schweitzer Fellowship?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_5_43'>(Please select all boxes that apply)<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_43'><div class='gchoice gchoice_5_43_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.1' type='checkbox'  value='I know a Fellow or former Fellow'  id='choice_5_43_1'   aria-describedby=\"gfield_description_5_43\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_5_43_1' id='label_5_43_1' class='gform-field-label gform-field-label--type-inline'>I know a Fellow or former Fellow<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_43_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.2' type='checkbox'  value='A faculty member or other staff at my school encouraged me to apply'  id='choice_5_43_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_43_2' id='label_5_43_2' class='gform-field-label gform-field-label--type-inline'>A faculty member or other staff at my school encouraged me to apply<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_43_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.3' type='checkbox'  value='I attended a Schweitzer information session'  id='choice_5_43_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_43_3' id='label_5_43_3' class='gform-field-label gform-field-label--type-inline'>I attended a Schweitzer information session<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_43_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.4' type='checkbox'  value='My school generally promoted it'  id='choice_5_43_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_43_4' id='label_5_43_4' class='gform-field-label gform-field-label--type-inline'>My school generally promoted it<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_43_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_43.5' type='checkbox'  value='Other'  id='choice_5_43_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_43_5' id='label_5_43_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_47\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_47'>Please specify.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_47' id='input_5_47' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_5_48\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_above gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >How have you engaged with the Fellowship so far?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_5_48'>(Please select all boxes that apply)<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_5_48'><div class='gchoice gchoice_5_48_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.1' type='checkbox'  value='I attended an Application Workshop'  id='choice_5_48_1'   aria-describedby=\"gfield_description_5_48\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_5_48_1' id='label_5_48_1' class='gform-field-label gform-field-label--type-inline'>I attended an Application Workshop<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_48_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.2' type='checkbox'  value='I attended a One-on-One'  id='choice_5_48_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_48_2' id='label_5_48_2' class='gform-field-label gform-field-label--type-inline'>I attended a One-on-One<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_48_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.3' type='checkbox'  value='Other'  id='choice_5_48_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_48_3' id='label_5_48_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_5_48_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_48.4' type='checkbox'  value='None of the above'  id='choice_5_48_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_5_48_4' id='label_5_48_4' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_5_49\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_5_49'>Please specify.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_49' id='input_5_49' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_5_50\" class=\"gfield gfield--type-multi_choice gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_above gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-horizontal\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Are you interested in being part of the Patient Navigation Program (PNP)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_text\">(Required)<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_5_50'>\n\t\t\t<div class='gchoice gchoice_5_50_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_50' type='radio' value='Yes'  id='choice_5_50_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_5_50_0' id='label_5_50_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice 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