F E L L O W S H I P A P P L I C A T I O N Complete all pages of this application and mail the original and EIGHT photocopies to the Chairman of the Fellowship Committee at the above address. This application and three supporting letters of recommendation must be received by 1 December 2006. No other documentation will be considered by the Committee. Applicants will be notified by the Society by 15 March 2007, and fellowships will be tenable after 15 May 2007. |
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| MAILING ADDRESS | |||
| Name ( last, first, middle name or initial) | |||
| Street address and apartment or box number | |||
| City, state, zip, country | |||
| Telephone number Fax number, if applicable | |||
| e-mail address: | |||
| AFFILIATION | |||
| Institution | |||
| Department | |||
| Rank | |||
| WORKING
TITLE OF BSA FELLOWSHIP PROJECT |
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| INCLUSIVE
DATES FOR REQUESTED SUPPORT: |
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| BUDGET FOR SUPPORT REQUESTED: | Transportation |
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Lodging |
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Meals |
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Research expenses |
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TOTAL |
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| OTHER FINANCIAL SUPPORT APPLIED FOR OR EXPECTED FOR THIS PROJECT | APPLIED FOR | ||
| Inclusive dates | Source |
Amount |
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| GRANTED | |||
| Inclusive dates | Source |
Amount |
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| EDUCATION (GRADUATE AND UNDERGRADUATE) | |||
| Institution | Degree and date | ||
| Field | |||
| Institution | Degree and date | ||
| Field | |||
| Institution | Degree and date | ||
| Field | |||
| MAJOR PUBLICATIONS | |||
| PREVIOUS POSITIONS | |||
| Rank | Institution |
Date |
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| Rank | Institution |
Date |
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| Rank | Institution |
Date |
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| PROJECT DESCRIPTION | Provide a summary outline not to exceed three
pages describing the purpose, scope, and significance of
the project, a detailed plan of work and timetable for
completion, and a description of the published form the
project will take. (Provide sample entries, if
applicable.) Please double space. Note: The BSA Fellowship Committee evaluates applications on the basis of whether the project makes sense in terms of existing scholarship, whether the applicant is qualified to undertake the proposed project, and whether a BSA stipend would make a significant difference to the completion of the project. |
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| REFERENCES | Please list the names of three persons whom you have asked to submit letters of reference. The letters should be written specifically in support of this application by persons in your field who are competent to judge the significance of the project. It is the applicants's responsibility to have the letters of reference in the Society's hands by December 1, 2006. | ||
1. |
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| Name | Rank |
Address |
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2. |
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| Name | Rank |
Address |
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3. |
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| Name | Rank |
Address |
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| Signature | |||
| Name (type or print) | |||
| Date | |||
