The Application Form (this file) - FDR Suite Restoration Project

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The Franklin Delano
Roosevelt Global
Fellowship Program
“The only way to have a friend is to be one.”
2012-2013 Application Form
For the summer of 2013 The FDR Suite Foundation at Adams House is pleased to offer a new grant to support
summer undergraduate field-research, experience or study in the areas of international relations, international
trade, economic affairs and development, global governance and affairs, international languages, humanities,
sciences or global medicine, to be guided by the spirit of FDR’s Fourth Inaugural Address: “Today, in this year of
war, 1945, we have learned lessons—at a fearful cost—and we shall profit by them. We have learned that we
cannot live alone, at peace; that our own well-being is dependent on the well-being of other Nations, far away…
We have learned to be citizens of the world, members of the human community. We have learned the simple truth,
as Emerson said, that, ‘The only way to have a friend is to be one.’”
Participants will be known as Franklin Delano Roosevelt Fellows.
The Foundation will award one grant this year. The size of the grant will vary depending on the country of
destination, length of stay, and type of program in which the recipient will be participating, as well as on the
applicant’s individual budget and financial need.
Current Harvard College freshmen, sophomores & juniors are eligible to apply, with special consideration given
to students from FDR’s own Adams House. The FDR Global Fellowships are restricted to students who 1) can
demonstrate family income below 60K* per year and 2) who would otherwise have to work during the summer
to meet term-time obligations. The Foundation will grant up to $6000 for summer expenses, as well as an
additional stipend of up to $4000 upon successful completion of the summer program to make up for lost summer
wages, the amount being determined by the student’s previous summer earnings.. The application deadline is
March 1 2013.
Please type your responses directly in the text boxes on the form.
• NOTE: Maximum family income levels are approximate; students whose family income slightly exceeds the
limit are still encouraged to apply.
Page 2 of 10
BACKGROUND INFORMATION
Full Name:
Student ID#:
Email:
Cell phone: (
-
Class Year:
Field of Concentration:
Overall G.P.A.:
-
)
GPA in Field of Concentration:
Campus Address
Address Line 1:
Address Line 2:
City, State:
Zip:
Country:
Campus phone: (
)
-
Permanent Address
Address Line 1:
Address Line 2:
City, State:
Zip:
Country:
Permanent phone: (
)
-
What is your average household income (the amount reported as income to the IRS by those claiming you as a
dependent) over the last three years?
Page 3 of 10
HONORS AND ACTIVITIES
Honors and awards received since enrolling at Harvard:
OUTSIDE SCHOLARSHIPS AND GRANTS
List any awards or grants since entering Harvard
EMPLOMENT HISTORY
Please list all fellowships, internships and jobs you’ve had since entering college. (FRESHMEN: enter your
Harvard work experience and last two summers of high school.)
Employer
Nature of Work
Dates of
Employment
Hours/Week
Total
Income
Page 4 of 10
EXTRACURRICULAR ACTIVITIES
Share information on the community service, sports, professional organizations or other extracurricular activities
in which you have participated, including the approximate time that you’ve spent on them weekly.
Activity
Hours/Week
PUBLICATIONS AND OTHER MEDIA
We’re interested in how you communicate your ideas. Please list anything you’ve published, either on paper or
digitally. Examples might be articles you wrote for the Crimson, your project blog, or a video you made for
YouTube.
Publication
Link/Description
Page 5 of 10
OUTSIDE FUNDING SOURCES
Please list the other sources of funding you’re applying to for your summer program. The Foundation actively
encourages you to apply for additional funding, especially if you feel our grant won’t fully cover your expenses,
but be aware that your combined awards cannot exceed the cost of your summer program, and the FDR grant will
be adjusted accordingly.
Funding Source
Contact/ Email Address
RECOMMENDATIONS
You will need a letter or recommendation from your faculty advisor or someone at Harvard associated with your
proposed summer program of study. If you wish, you may also provide a secondary letter of recommendation
from someone associated with your academic life. Neither letter should be written by your fellow students.
List the recommendation writer’s name and phone number:
Name:
Phone: (
)
Email:
Additional recommendation writer’s name and phone number (if applicable):
Name:
Phone: (
)
Email:
Page 6 of 10
SUMMER PROGRAM OUTLINE
In 750 words or less, please outline the summer program you intend to pursue.
Page 7 of 10
Page 8 of 10
ESSAY QUESTION 1
In 750 words or less, please describe how your summer plans fit into the Foundation’s stated goals of promoting
the spirit of FDR’s Fourth Inaugural Address, specifically: “We have learned that we cannot live alone, at peace;
that our own well-being is dependent on the well-being of other Nations, far away… We have learned to be
citizens of the world, members of the human community. We have learned the simple truth, as Emerson said, that,
‘The only way to have a friend is to be one.’”
Page 9 of 10
ESSAY QUESTION 2
As part of your award responsibilities, you will be asked to send biweekly reports and photos during your summer
experience, which we may choose to publish on-line to our supporters. What other ways might you envision
expanding the visibility of the FDR Global Fellowship program during the next academic year, both at Harvard
and abroad? Examples might be giving a lecture to interested students at Adams, designing a continuation of your
summer program at Harvard, involving your peers in your efforts, proposing a joint program with another
organization, etc. Please answer in 250 words or less.
Page 10 of 10
APPLICATION PACKAGE AND INSTRUCTIONS
Your application should include all of the following:
Application Element
Submission Instructions
The Application Form (this file)
Email
Three essays
Email
A Letter of Recommendation
Emailed by the recommendation writer with a contact number
included for verification purposes
An Official Harvard College
Transcript
Scan and email
Signature (this page only) along
Scan and email
with a photograph of yourself. This
doesn’t need to be a formal
portrait/passport photo etc but will
be shared with members of our
selection committee who might be
unavailable to meet you in person.
SIGNATURE
Provide your signature here: ____________________________________________________________
Print your name here: __________________________________________________________________
Thank you for applying for the scholarship. The information we’ve requested will only be used for the purpose of
determining the scholarship recipients. Applications will be kept on file until each student has graduated from the
College. Feel free to send an email to michaelweishan@fdrsuite.org with questions.
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