University Grants and Enrichment - Sponsoring Research Programs

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1 Institute Themes Please indicate which Institute theme(s) you would be interested in hosting. You may choose to apply to host up to two Institutes in two different thematic areas. No university may host two Institutes of the same track (i.e. Universities cannot host two cohorts on the Civic Leadership track). You will need to submit a separate 6 page syllabus overview and budget for each theme you select: Business and Entrepreneurship Civic Leadership Public Management Specialized Institute: Energy IREX will place Fellows at universities based on interest areas in the themes below. The goal is to place each Fellow at a university that has particular expertise/resources that match their interests. For this purpose, please check up to five subthemes in the list below in which your university has expert faculty or strong campus/community resources. Agriculture Arts/Music/Fashion Banking/Finance Business/Entrepreneurship Children and youth Civil/Human Rights Community Development Construction/Architecture/Real Estate Democracy/Governance/Civic Education Disability Rights/Issues Education Energy Engineering Environment/Conservation/Wildlife Government: civil service Government: elected office Health/Public Health/Medicine Hospitality/Tourism/Travel Journalism/Media/Publishing Justice/Legal/Prison Systems LGBTQI Issues Manufacturing Communications/Marketing/Advertising Peacebuilding/Conflict Resolution Policy Advocacy/Research Public Works (utilities/water/waste management) Religion Retail/Sales Science Technology/Telecommunications Transportation Women s and girls Issues

2 Page 2 Section 1: General Information Universities proposing to host two Institutes must include the names of separate Academic and Administrative Directors for each Institute. Universities may propose to host up to two Institutes in two different thematic areas. No university may host two Institutes of the same track (i.e. Universities cannot have two cohorts on the Civic Leadership track). Name of Institution: Name of Principle Contact Person: Title: Name of Department: Telephone: Address 1: Address 2: Mailing Address: Name and Title of Academic Director *: of Academic Director: Name and Title of Administrative Director*: of Administrative Director: * Please attach resumes for your proposed Academic and Administrative Directors

3 Page 3 Section 2: University Support and Logistics For universities proposing to host two cohorts, you only need to complete Sections 2-4 of this application once, but please make sure to reference faculty and resources specific to each thematic track where relevant. 1. Describe the university support that will be present for the implementation of the 2016 Mandela Washington Fellowship. For example, from which departments will faculty and lecturers be drawn? How is the senior university administration involved? * Please attach a letter of support from the university s senior leadership. 2. Describe access to transportation within your community. Please confirm that your transportation budget includes all domestic airport transfers (from the airport when Fellows arrive and to the airport when Fellows leave for the Summit), all transportation to and from site visits, to and from cultural activities, and to and from any other program activities. 3. Describe your proposed housing for the fellows, including whether bedrooms and/or bathrooms are shared. This should also include information on provisions for cleaning and laundry facilities. Please confirm that you will be able to provide all necessary bedding, towels, and basic sundries within the budget.

4 Page 4 4. Describe your proposed meal options for the Fellows. Please confirm that you will be able to provide a mix of prepared meals (i.e. dining hall options) and cash for Fellows to buy groceries or eat some meals at local restaurants of their choice. Please advise if Fellows will have access to cooking facilities and explain how Fellows will be able to get to and from a grocery store. Please also advise how you will accommodate Fellows with dietary restrictions or who may be fasting for Ramadan during the Institute. 5. Mandela Washington Fellows are covered under the U.S. Department of State s Accident and Sickness Health Benefits Program (ASPE) ( Please confirm your willingness to help Fellows identify and access appropriate medical care and describe your staffing plan to support Fellows who need to seek medical care. 6. The Mandela Washington Fellowship strongly promotes the inclusion of Fellows with disabilities and is seeking host university partners that are similarly committed to ensuring a high quality, inclusive program for all Fellows. Please discuss your program team s capacity and willingness to provide accommodations for Fellows with disabilities in your Institute. Please also explain the support your university can provide to your team with respect to disability accommodation. Direct program costs associated with disability accommodation on campus can be paid directly by IREX and are not expected to be included in your subaward budget, although cost-share for disability accommodations is allowable and strongly encouraged.

5 Page 5 Section 3: Institute Program Elements For universities applying to host two cohorts, please ensure that your responses in this section cover resources and programming available for each cohort. These sessions will be more successful if particularly tailored to the institute tracks rather than the university as a whole. 1. Please include a brief description of your plan for orienting Fellows both at the beginning of the program and the start of each week. 2. To support professional development and community engagement, universities are asked to make connections among Fellows and U.S professionals (peer collaborators) in their communities. Peer collaborators are individuals of a similar age, background, and interests who volunteer to be matched up with Fellows as part of a mutually beneficial professional enrichment experience. While this does not need to be a one on one match, the ratio of peer collaborators to Fellows should be as close to 25:25 as possible. Please provide an overview of how you will recruit and incorporate peer collaborators into your Institute. 3. Briefly describe community engagement and networking activities planned to introduce Fellows to Americans (both professionally and personally) in your community. 4. Provide an overview of the proposed hands-on community service activities during the Institute and how they will relate to your overall program themes and objectives. Who are the proposed partners? How will the activities be structured? Will Fellows participate in activities as a whole group, or in smaller group?

6 Page 6 5. Describe your proposed leadership skills-building activities during the Institute. How are these activities structured within the 6 weeks? 6. You will be hosting a group of leaders who will provide feedback on things that are working for them and things that are not working. How will you gather and incorporate this feedback from the Fellows during the Institute? Section 4: University Resources and Past Performance 1. Describe your institution s experience designing and implementing short-term customized academic programs for adult learners with a focus on experiential learning. 2. While it is anticipated that Fellows will learn from their hosts, it is also important that hosts learn from the Fellows. Please indicate how you anticipate your campus and community will benefit from hosting these leaders.

7 Page 7 Submission Did you include? Completed Application Form - Sections 1, 2, 3 and 4 Resumes for Academic and Administrative Directors Letter of Support from University Senior Leadership Syllabus Overview (6 pages maximum) Budget Worksheet and Narrative Please send all materials to IREX at mwf2016@irex.org no later than 5:00 pm Eastern Time on October 27, 2015.

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