APPLICATION FOR
R. J. McELROY FELLOWSHIP
By January 29, 2016 submit two copies of the application and the supporting materials to the
University Honors Program, 2401 College Street (campus mail code 0355). Please do not submit
handwritten applications. As you complete the form you are welcome to add more space as
needed. Please try to limit your application to two pages.
Date:
PERSONAL INFORMATION
1. Your name (First, Middle, Last):
2. Your current contact information
Address:
Phone number(s):
E-mail Address:
3. Your date of birth:
EDUCATIONAL ATTAINMENT AND PLANS
4. What Iowa college or university are you currently attending?
5. What is your major and minor course of study?
6. When will/did you graduate? (Month, year)
7. What degree will/did you earn?
8. If available, what is your G.R.E. Score?
9. At what graduate college/university will you be studying next year? Have you been accepted?
__Yes __No
10. If you are undecided, where have you applied? Please indicate to which schools you have already
been accepted.
11. Do you plan to begin your graduate studies toward a PhD this coming fall? __Yes __No
12. What is your graduate field?
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13. Have you earned other financial assistance for your graduate studies? __Yes __No __Not Sure
Yet
If yes, explain:
14. List awards, honors, and prizes earned while in college (e.g. Phi Beta Kappa, Dean's List, athletic
letters, etc.)
15. List positions of academic and extra-curricular leadership you have held or now hold:
Signature of applicant ___________________________________________Date:______________
REQUIRED ATTACHMENTS
1. Attach a one-page letter outlining your graduate school objectives and career plans.
2. Attach a copy of your most recent available transcript.
3. Attach a recent photograph.
4. Your application must be supported by recommendations. Please list the names of persons from
whom you have requested letters of recommendation. (Do not attach letters to this application, but request
that references send their letters directly to University Honors Program, 2401 College St, mail code 0355.)
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Your department head (Name, institution, office address)
Your major advisor (Name, institution, office address)
Your character reference (Name, occupation/profession, office address)
Mail or deliver two (2) copies of application and supporting materials by January 29, 2016, to
the University Honors Program, 2401 College Street (campus mail code 0355).
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