аЯрЁБс>ўџ ўџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџмЅhcр e­K­ &p=jnnnnnnnnpppppp­XFpn nnnnpnn<.nnnnnnn-&ЖnnnnPlease complete the Applicant Data and the Statement of Purpose sections of this document, then print them and mail them along with Original College Transcripts (not photocopies) and three (3) Letters of Reference. Part of this document is a blank Letter of Reference form. Please insert your name into the Letter of Reference form, then print three copies of that form for your references to complete and sign. Once you have completed the application form and assembled the transcripts and letters of reference, please mail them to: Dr. Malinda Fitzgerald, ATTN: MIRT Program Christian Brothers University 650 E. Parkway South Memphis, TN 38104-5581 Applicant Data Last Name: First Name: Middle: Current Mailing Address: Current Phone Number: ( ) Permanent Mailing Address: Permanent Phone Number: ( ) PRIVATECan you provide documentation of US citizenship or US permanent residency status? Your current major and/or program in which you are enrolled or to which you have been accepted for fall 2001: Describe any experience you have with pediatrics, cancer, laboratory, and/or languages. What are your long-term career goals? If selected you will be traveling to Brazil. Do you agree to be tutored in conversational Portuguese two sessions per week this February а May? Please indicate your 1st, 2nd, and 3rd choices for research projects that interest you: _____ Basic research on neuroanatomy of the visual system _____ Clinical research on handwashing by health care providers _____ Global bioethics _____ Other (Please describe): How did you hear about this MIRT program? If someone told you about the program, we'd appreciate learning their name. Statement of Purpose The Statement of Purpose is a critical part of the application and should include: Why you want to conduct research abroad and how it will further your specific research project; Your specific career objectives that relate to international study/research; How you will apply your study abroad experience to your academic work upon returning to your home institution; and Why you feel particularly suited or qualified to pursue this program of study. (Please type your statement of purpose here. You may use more than one page if necessary.) Letter of Reference Letter of Reference forms are to be distributed by applicant to references. Individuals providing a reference should complete the reference form, place in a sealed envelope, sign across the flap and return to the applicant to be submitted with the other parts of the application. Dear Dr. Fitzgerald, I am writing this Letter of Reference in support of [please insert applicant name here]еs application to the Mid-South Coalition for Minority International Research Training program. (http://www.cbu.edu/~aross/biodept/MIRT-CBU.html) How long have you known the applicant? In what capacity? Signature: Date: Title/Position: Phone #: Ё—œ  Єа/Ѕр=І Ї Ј Љ ЊЫ:~ЄНиЃриЃйЃЄЄŒF ЁЋЌИЙКСТїџ7?@ABIJKœžŸ efŒŽ68;=DF‘ * + - Ѓ Є К Л p q О П 1 3  ƒ „ ќјіђьчьчуьчьруьрумЭЧЗЭВАВЌВАВАВАВІВІВІВœВЌВАВАђАšАšАšАš–U]b]BEFjKJ&U]c U]ch]ccU]cuDаBCEF] KfU]cG CU]cuDBCEF] KfU]cUb cbcUbc]bc U]bcU]b U]c]c;„ р с т і ї   Z [ ~ 5Ќ­›ќњієяыхяєрєоuU]c U]b c]cU]ccU]b cbcŸ Fdy‘ Ё­КУФ§ўџ=>?@AžŸ fgŽ xyўўўќњіііўўќђђђђђыхыђоооойЯђђђђђђђђђђђ ОЄПТТТа%yГДєѕ , - Є К Л   q П 3 ƒ „ р с і ї   & ' ‘ р ќќќќќќќќќњјјјггггбЭЭњјЫЫЫЫЫЫШјјјјјјј$ ˜ў 4џhЗhТ$ !"#$%&'()*+,-./012345\]opqr‹Œ­ўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўўў%K @ёџ Normal ]a c&@& Heading 1 U]b c "@" Heading 2аU"A@ђџЁ"Default Paragraph Font&ўOђ& Blockquotehhdd B@ Body Text]b­ ­џџџџ„ › y­ .UnknownfoobarDr. Malinda Fitzgerald­ џ@=MTimes New Roman Symbol "MArial MTimes"€€аh] KF] KFА  ƒFApplicant Data Form Ron VulloDr. Malinda Fitzgerald ўџџџ§џџџўџџџўџџџўџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџRoot Entryџџџџџџџџ РFхГDР€WordDocumentџџџџKCompObjџџџџџџџџџџџџXSummaryInformation(џџџџџџџџИўџџџўџџџ ўџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџўџџџџџ РFMicrosoft Word DocumentўџџџNB6WWord.Document.6ўџ р…ŸђљOhЋ‘+'Гй0ˆ˜ДРдрьќ ( D P \hpx€'Applicant Data Formppl Ron VulloDaon on NormallDr. Malinda Fitzgerald61. 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