Application Form

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HARRY J. CANON FELLOWSHIP
Application for Spring or Summer 2015 Fellowship
Supportive Professional Staff and Operating Staff members with at least one year of NIU work experience
have the opportunity to gain practical experience in a different University department in order to broaden
their skills and span of knowledge.
Fellowship option*
_______ Option I: Generally, 4-6 hours per week, depending on goals and objectives of the applicant
_______ Option II: Mentor program, time commitment determined by mentor/protégé
Fellowship period*
_______ Academic Year (Start date:____________________; End date:_____________________)
_______ Semester (Start date:______________________; End date:_____________________)
_______ Consecutive Summers 2014/2015
*Note:
Alternate Fellowship options and Fellowship periods may be proposed by the applicants and presented
to the Awards & Professional Development Committee for consideration.
Applicant Name: _______________________________________________________________________
Department: ________________________________ Title:_____________________________
Number of years employed at NIU: _______
Please address the following, typing directly onto this form. NOTE: Typing directly on this form will
automatically insert any space that you need to adequately address the questions below.
1. Briefly describe your present responsibilities.
2. (a) List college degrees earned and majors; and (b) other degree(s) in progress, major(s), and credit hours
earned to date.
3. List any other work experiences in Student Affairs & Enrollment Management and/or other experiences
which illustrate interest in, or skills applicable to, higher education administration.
4. (a) Describe your proposal for participation in the Fellowship. Include your goals and objectives for this
Fellowship, expected time commitment, individuals with whom you desire to work, and the experiences in
which you expect to become involved. (b) Outline your career goals as they relate to higher education
administration and how you feel the Fellowship will aid you in realizing these goals.
5. Include a copy of your résumé with submission.
Department Director Approval
Department Directors need to send a confirmation e-mail to abranson@niu.edu indicating approval of the
individual’s participation in this program (see Canon Fellowship Qualifications listed below). Please include
the following text in the body of the e-mail:
I agree to provide release time to ______________________ should he/she be awarded the Canon
Fellowship. We have discussed how his/her regular responsibilities will be covered during the period
of the Fellowship and have come to a mutually satisfactory agreement.
Name of Department Director: ___________________________________________________
Fellowship Director or Mentor Approval
Fellowship Directors need to send a confirmation e-mail to abranson@niu.edu indicating approval of the
individual’s participation in this program. Please include the following text in the body of the e-mail:
I agree to serve as a mentor to _____________________ for the Canon Fellowship as outlined in the
applicant’s proposal. I have discussed the applicant’s Fellowship proposal with the applicant, and I
agree to work with the applicant to meet the goals and objectives outlined.
Name of Mentor: _________________________________________
Name of Mentor’s Department Director: _________________________________________
Department: ______________________________
Canon Fellowship Qualifications
o Applicant must be a full-time employee (minimum of 1 year by start of Fellowship).
o Applicant must have a Bachelor’s degree.
o Applicant must have his/her Director’s approval/signature (awarding of Fellowship is contingent
upon applicant being in good standing and upon department’s operational needs).
o Applicant must have approval/signature of Mentor and of Mentor’s Director.
o Fellowship must be consistent with applicant’s demonstrated interest and future. Career plans and
goals of the applicant must fall within administration in higher education.
IMPORTANT INFORMATION
Canon Fellowship Begin Date
Application Due Date
After January 1, 2015 (Spring or Spring/Summer
Fellowship)
After May 15, 2015 (Summer or Summer/Fall
Fellowship)
After August 15, 2014 (Fall or full-year Fellowship)
October 24, 2014
February 23, 2015
February 23, 2015
 Submit nominations to Angela Branson via email to abranson@niu.edu or personally deliver to
Altgeld 208
 Applicants are responsible for ensuring that all materials are received by the designated deadline
 Applicants may be contacted for additional information
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