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CCPR Affiliate Application

Please complete the following form to apply for CCPR affiliation

Request Type
Please select the option that describes the affiliation you are seeking: Faculty Affiliates: any full-time or emeritus UCLA faculty member interested in population research. Graduate Student Affiliates: UCLA graduate student interested in population research and have a CCPR faculty affiliate as his/her primary advisor or a member of their graduate committee, or work for a faculty affiliate as a research associate. External Affiliates: CCPR Affiliates who have a new or long-standing collaboration with a colleague at another institution may nominate the colleague as a CCPR non-resident affiliate. Postdoctoral Affiliates: postdocs who have postdoctoral appointment at UCLA. CCPR does not have postdoc positions. (for Matt: if an applicant select this type of affiliation, please have another field for uploading the postdoc appointment letter.) Visiting Researcher: Faculty members or Graduate Students who have UCLA Visiting Researcher or UCLA Visiting Graduate Researcher appointments, interested in population research, and sponsored by a CCPR faculty affiliate. (for Matt: if an applicant select this type of affiliation, please have another field for uploading the UCLA Visiting Researcher Appointment Letter)
Previously Earned Degrees
Please list your previous earned degrees in the format of Degree, Year Graduated, Major or Area of Study, School or Educational Institution (example : B.A., 2019, Social Sciences, UCLA) Please list each degree on a new line.
  • {name}
Please provide 2-4 interests that summarize your research interests to be displayed under your photo on the website. Use as few words as possible (Example: Aging, Diabetes, Ethnic disparities, Access to healthcare)
Purpose
Please provide a short explanation of why you would like to be affiliated with CCPR
  • {name}
Recent Photo
A recent photo of you to be included with your application. To see examples, please visit our People page https://ccpr.ucla.edu/people/
Attach file
Drop files here
CCPR Photo Use
Please check to agree that you give permission to CCPR to use your photo on the CCPR website
Notes
Please include any other information that you may wish to provide here.
  • {name}

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