Fellowship Application

Please complete the following form as well submitting the supporting documentation as noted.

Application Period: January – April 2026
Fellow Confirmation: June/July 2026
Contact: info@duperreaultfellowship.org

 

"*" indicates required fields

SECTION 1: PERSONAL INFORMATION

DD slash MM slash YYYY
Bermuda Status*

Contact Information

SECTION 2: EDUCATIONAL BACKGROUND

Highest Level of Education Completed*

SECTION 3: PROFESSIONAL EXPERIENCE & COMMITMENT

Current Employment Status
Relevant Skills and Expertise*
Please describe your experience in areas such as

SECTION 4: SPONSORED AGENCY AFFILIATION

Sponsoring Agency/Institution Information
Type of Organization

SECTION 5: EDUCATIONAL GOALS & COURSE OF STUDY

Proposed Program of Study
Degree Level
Field of Study
Proposed Training Area
Select your primary area of focus

SECTION 6: PERSONAL STATEMENT

Please provide a one to three-page personal statement

Your personal statement should convey:

  • Your commitment to the substance use disorder/addiction-focused prevention and intervention field
  • The experiences you seek as a result of this commitment
  • Your goals within the field
  • Why have you chosen this course of study at this time in your life
  • Your personal views regarding issues within the field

The Committee seeks evidence of your thorough commitment to the field, a well-developed academic and vocational plan, working knowledge of behavioral health, understanding of key concepts, critical thinking skills, and capacity for clarity of expression.

 

SECTION 7: TWO LETTERS OF RECOMMENDATION

The Committee requires two letters of recommendation from individuals who can speak to your:

  • Character and commitment to the field
  • Academic ability and potential
  • Professional capabilities and experience
  • Community involvement

Recommender 1

Max. file size: 10 MB.

Recommender 2

Max. file size: 10 MB.

SECTION 8: FINANCIAL INFORMATION & REQUEST

Financial Need Assessment
Annual Income (Approximate)

Estimated Program Costs

SECTION 9: COMMITMENT & UNDERTAKING

Post-Completion Service Commitment

SECTION 10: DECLARATION

By submitting this application, I certify that the information provided is true, accurate, and complete to the best of my knowledge. I understand that any false or misleading information may result in my application being declined or the withdrawal of any award granted.

I acknowledge that the Duperreault Fellowship Committee reviews all applications and makes selections at its discretion based on academic excellence, technical skills and experience, overall quality of the application, career plan, and anticipated benefits to the Bermudian community.

Clear Signature
Max. file size: 10 MB.