Kent State University College of Education, Health and Human Services School of Teaching, Learning and Curriculum Studies Application for the Richard and Jo Anne Vacca Fellowship for Teachers of Literacy Name ____________________________ Email: _____________________________ Student ID# ____________________ I am applying for the (check one) _____ Master’s scholarship ____ Doctoral scholarship (Check One) _____Fall Semester _____ Spring Semester ____ Summer Semester When were you admitted to the C& I Master’s or Doctoral Program? ________________ Who is your advisor? ________________________ When is your anticipated graduation date? ____________________________ Home Address (street, city, zip) _______________________________________________ Home Telephone Number: ___________________________________________________ Current Teaching Position ____________________________________________________ (School) _____________________________________________________________________________ (Street & Number) (City) (State) (Zip) _____________________________________________________________________________ (Subject & Grade(s)) What class will you take as a result of this scholarship? ________________________________ What are your professional goals for the next five years? How would this scholarship help you achieve the goals? Please provide a professional reference who is aware of your goals: ___________________________________________________ _________________________ (Reference’s Name & Position) (Telephone) ____________________________________________________________________________________ (Address) Applicant’s Signature:__________________________________Date:_________________________ Please email this application to Sherry Ernsberger (sernsber@kent.edu)