Date: ________________
PUBLIC INTEREST LAW PROGRAM FELLOWSHIP APPLICATION
Student Name: __________________________________________________
Student Telephone No.: ____________________________________
Year in Law School _________________
Student E-Mail: _____________________________
Public Interest Organization: _____________________________________________________________________________________
(include city/state)
Supervisor’s Name/Title: _______________________ Email: _____________________ Telephone No.:_____________
Anticipated Start Date: _____________________________________
Please calculate total number of
hours you will work: __________________
Anticipated End Date: __________________________________
Number of Hours to Be Worked Per Week: ___________
Will any hours count toward Clinical Seminar Credit? Yes
No If Yes, how many hours? _____________
Are you receiving any other funds for this work? Yes
No If Yes, what is the source of the other funds?
____________________________________________________________________________________________________________
Position Duties/Principal Area(s) of Practice:
Learning Objective(s):
Have you received a previous Public Interest Program Fellowship? Yes
No
If yes, when did you receive the award?
Semester ______ Year _______
How much did you receive?
$_________ for ____ hours of work (approx.)
I have read and signed the Statement of Student Professionalism1: Yes
No
2
I attended / supported the SBA auction :
Yes
No
If so, how?
You must complete the Statement of Student Professionalism and submit it with this Application. Copies are available in the
CPPO office and online at: http://www.uakron.edu/law/career/students/resource-library.dot
2
Your award shall be tied to your responses to these questions.
1