DSTF Candidate Form Please complete this form to nominate a student for DSTF (Doctoral Student Tuition Fellowship). Funding is NOT guaranteed. Doctoral students are priority. Remaining funds, if any, will then be disbursed to qualified MSW students. Those approved will be eligible for up to 21 semester credit hours per academic year. Students must indicate below the number of hours they wish to have funded per semester. To be completed by Student: Student Name Student People Soft Number Student Email Address Number of DSTF Hours previously funded (this AY) Number of hours to be funded this semester I understand that the Doctoral Student Tuition Fellow program funds up to 21 semester credit hours per calendar year. I understand that funding is subject to availability and approval of the GCSW scholarship committee. If at any time, I am not in compliance with the terms of the DSTF policies, my funding will be revoked until further review. To be completed by hiring department: Direct Supervisor’s Name Direct Supervisor’s Email Address Direct Supervisor’s extension Hiring Department I certify that the above listed student is currently in compliance with the GCSW DSTF terms and policies. If at any time, the student is no longer in compliance and will not meet the criteria for the DSTF, I agree to notify the Office of Student Affairs. Revised June 24, 2013