Application for Program & Resident Fellowships

International House
Application for Program & Resident Fellowships
Spring 2014
Last Name:
Room #:
First Name: ____________________________
Cell phone #:
Email (Preferred): ______________________________________________________________
Country of Origin: ___________________ Permanent Residence:
Date of first arrival at I-House: ___________________________
Field of Study/Concentration: _________________________________________________________
Academic/Training Institution during the 2013-14 academic year: ___________________________________
Degree & Expected Graduation Date:___________________________________________________________
Status for the next academic year (circle one): Student Trainee Intern Scholar Other:_______________
NOTE: You must apply and be approved by the Admissions Office for resident membership for the 2013–2014
Academic Year to be eligible for a fellowship position. If you have any questions about your status, please
contact the Admissions Office.
Please list I-House Scholarships and/or Program/Resident Fellowships, including dates:
Please list I-House programs and activities you have participated in as a resident member including
any leadership roles/positions:
Why is this fellowship of interest to you?
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On a separate sheet of paper, please describe your interests, skills and experiences that qualify
you for each of the fellowships for which you are applying. Please attach your resume or C.V.
Please list any outside commitments you will have next year. Include employment, internships, etc.
Please list at least one professional reference whom we may contact if you are a finalist for a
fellowship. Please give the person’s name, relationship to you, and telephone number and e-mail
Name & Title: ____________________________________________________________________
Relationship: __________________________________
Telephone: ____________________ E-mail address: _________________________________
Mandatory Dates
All Resident Fellows, Equipment Technicians, and Program Fellows (except Summer Fellows) are required to
attend Team Training and Leadership Weekend. These dates are as follows:
 Program Fellow Team Meetings: 1/21; 2/25; 3/25; 4/22;
 All Nations Celebration: 4/5
Do you foresee any conflicts in your schedule with these dates? _____________________________
All the information submitted here is true and accurate. If selected, I understand that my name and
photo/video may be used for Programs publicity purposes.
Signature______________________________________________ Date____________________
Please return this form with a statement describing your interest
in the Fellowships you are applying for and a copy of your resume/CV to the
Programs & Resident Life Office or email it to