First Name * Last Name * Dartmouth ID Number * Dartmouth Email Address * Graduate Program/Affiliation * - Select -GeiselGeisel/TuckGraduate SchoolTeaching Science FellowThayerThayer/TuckTuckOther If Other Degree * - Select -BEEmployeeMAMBAMDMD/MBAMD/PhDMMEMPHMSPhDOther If Other Department/Area of Focus * Date Started in Program * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year201420152016201720182019202020212022202320242025202620272028202920302031203220332034 Projected Graduation Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year201420152016201720182019202020212022202320242025202620272028202920302031203220332034 Dates you expect to be away from campus during the upcoming academic year * This question is for application purposes only. Absences still have to be requested from supervisor once hired. Resume or CV Please upload document as PDF and name it as follows:"YourFirstName YourLastName Resume"OR "YourFirstName YourLastName CV" Resume or CV * Upload Files must be less than 20 MB.Allowed file types: pdf. Statement of Interest (up to 500 words) Why would you like to be a Resident Fellow in Dartmouth’s House Communities? What mentoring and/or tutoring experience and training have you had? What are your long-term career goals? * Recommender Information Please ask two individuals to submit recommendations on your behalf. One should be your academic advisor/mentor. At least one needs to be a current Dartmouth faculty or staff member. It is your responsibility to point your recommenders to the correct form and to follow up with each individual to ensure that they have submitted the required information by the deadline. Full name of first recommender * Email address of first recommender * Full name of second recommender * Email address of second recommender * Endorsement from Primary Advisor Please ask your primary advisor to submit a statement endorsing your candidacy for this role. It is your responsibility to point your endorser to the correct form and to follow up with them to ensure that they have submitted the required information by the deadline. Full name of primary advisor * Email address of primary advisor * Applicant Signature Typing your full name in this text box will serve as a digital signature. * It is your responsibility to ensure that all parts of your application, including recommendations and endorsement, are completed by the deadline.By submitting this form, you are certifying that you have read and understood the information provided about the position, including the important information regarding laws and policies. Submit