Diversity Track – NACDS Foundation Scholarship Application

School/College of Pharmacy Name:*

Pharmacy School Dean Name:*

Pharmacy School Dean Email Address:*

Pharmacy School Dean Phone Number:*

Primary Contact for Application:*

First Last

Primary Contact’s Email Address:*

Primary Contact’s Phone Number:*

Is the school or college of pharmacy fully accredited by ACPE? Schools not yet fully accredited by ACPE will not be eligible for an award.*

Briefly describe the proposed project or program, including high level goals and objectives.*

Please note this application is for the diversity track scholarship award. All information for the innovation track should be provided in the innovation track scholarship application. (150 - 200 words)

Does this proposal outline a new project or program, or expand an existing program?*

Is this application submitted in collaboration with another school/college of pharmacy?

Yes
No

List full, official name of collaborating school.*

The Foundation welcomes project origination and project expansion. Please explain your response above and how this requested funding will be used to support an initiative in a new or innovative way if program/project is already underway.*

Describe the scope of community and pharmacy school student involvement in proposed program.*

Describe how the proposed program aims to foster health equity.*

Please provide estimated numbers of students impacted and involved in this proposed project or program.*

Can this program or project be fully implemented with current COVID-19 social distancing guidance in place in your state and school/university? Please explain.*

Please upload a description/proposal addressing the following bullet points (total length: 3-5 pages).*

Program Activities: Describe the proposed program activities. Include descriptions of the following: the unmet community and/or curricula need the program addresses; scope of student and faculty involvement; and patient care/pharmacy practice innovation. Particular focus should be on how proposed project or program aligns with NACDS Foundation’s vision to support “research and educational initiatives that benefit patients, improve outcomes, and advance public health.”

Implementation Approach & Timeline: Describe how the program will be implemented over 12 months. Include a timeline of program milestones to be achieved.

Community Outreach, Health Equity and Student Involvement: Describe the scope of community, health equity and pharmacy school student involvement in proposed program.

Program Outcomes: Describe how program success will be evaluated. Include how outcomes will be measured throughout the program including data such as faculty, student and/or patient involvement, number of practice sites, improved patient care and student competency.

Max. file size: 50 MB.

Please upload your proposed budget, including an itemized plan.*

Please upload your proposed budget, including an itemized plan. Please use the NACDS Foundation Budget Template as a guide. NACDS Foundation grants diversity track scholarship awards of up to $15,000, though award amounts vary each year. Please see NACDS Foundation’s FAQs page for more information on allowable expenses.

Max. file size: 50 MB.