Prospective Fellowship Applicant Info Sheet
Fellowships Office, Dewey 4-209B, 276-5869, fellowships@rochester.edu
Name
Today's Date
Graduation Year
Cumulative GPA
Student ID #
Major(s)
Minor(s)
Certificate(s)
E-mail
Phone #
Campus Box number or Local Street Address
Citizenship
State of legal residence
If not a U.S. citizen, are you a permanent resident of the U.S.? Yes
No
If you are seeking citizenship, when do you expect to become a U.S. citizen?
Extra & Co-curricular activities (e.g., social, cultural, academic clubs/organizations, student government, RA, TA,
community service, athletics, performing arts, internships; Indicate any leadership positions held and period of
involvement):
ON-CAMPUS ACTIVITIES
OFF-CAMPUS ACTIVITIES
- Academic awards, other honors, special recognitions (give date & sponsor):
- International experience, past / future (indicate what program, where, when, how long):
- Post-graduation plans / career aspiration (e.g., Ph.D. in history, M.A. in urban planning, M.D., J.D. / professor,
high-school teacher, public official, physician, environmental engineer, epidemiologist):
- Awards of interest (please check):
Beinecke
Boren/NSEP
Carnegie Jr.
Churchill
CLS
DAAD-RISE
Davis Peace Grant
Fulbright
Fulbright UK Summer Inst.
Gates Cambridge
Goldwater
Humanity in Action
Marshall
NIH UGSP
PPIA
Rhodes
Schwarzman
Soros
Truman
Other Award(s):
NSF GRFP
Udall