Delores A. Auzenne Fellowship
Application Materials
IMPORTANT: READ AND RETAIN FOR YOUR RECORDS
Deadline for Application Materials to be received
By Florida Atlantic University:
APRIL 15, 2005
Funds for this program are allocated by the Florida Board of Education and are contingent upon continued
annual support by the State of Florida
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DELORES A. AUZENNE FELLOWSHIP
-APPLICATION PACKETFlorida Atlantic University announces the availability of the Delores A. Auzenne Fellowship Program
for minority students. This program, sponsored by the State University System, is designed to
encourage minority students to pursue graduate degrees in areas where they are historically
underrepresented at Florida Atlantic University. These areas include, but are not limited to:
engineering, mathematics, computer science, economics, and psychology. The program provides
support in the amount of $5,000 to each awardee for one academic year of full-time study in
selected disciplines. The grant will be available pending Legislative approval.
TO BE ELIGIBLE FOR RECEIPT OF THIS AWARD , THE STUDENT MUST BE:

Accepted (of degree-seeking status) in a graduate program at FAU (Full-time enrollment will
be confirmed prior to the distribution of program funds);

Pursuing a graduate degree in a discipline in which minority students are underrepresented;

Demonstrate the likelihood of satisfactory progress in achieving the desired degree;

Meet eligibility requirements for an award of state financial aid; and

Be a citizen or permanent resident of the United States.
Students pursuing masters and professional degrees may be selected for a second-year award.
Doctoral students may be selected for the award up to four years. However, a new application form
and supporting documentation must be submitted each year.
To expand opportunities to as many students as possible, recipients of graduate student aid,
including but not limited to Virgil Hawkins, Patricia Harris (GPOP), and the Florida Endowment Fund
for Higher Education, will not be considered for the Auzenne Fellowship.
Applications are currently available in the Equal Opportunity Programs office at Florida Atlantic
University. APPLICATIONS AND NOMINATIONS WILL BE ACCEPTED UNTIL 5:00 P.M. ON
FRIDAY, April 15, 2005 for the 2005-2006 academic year. Applications left after this time will not
be considered. Only completed packets will be considered.
For more information, please contact Stanley Strutz, Associate Director, Equal Opportunity Programs
office at (561) 297-3004, or visit Room 291 of the Kenneth R. Williams Administration
Building.
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Auzenne Fellowship Program Criteria:
The Auzenne Fellowship will provide $5,000 for full-time graduate study during the 2005-2006
academic year. Students enrolled in masters programs may receive up to 4 semesters of funding
under this program. Students enrolled in doctoral programs may receive up to 8 semesters of
funding under this program.
PLEASE INCLUDE THE FOLLOWING WITH THIS APPLICATION:
!
Transcript(s) from all institutions attended.
!
A one- or two-page statement on how this fellowship will assist in the achievement of your
career goals.
!
Three current letters of reference; at least one from a professor who is familiar with your
academic work.
Responsibilities of Recipients:
The program requires that you maintain full-time student status and that you report any change
in this status to the Director of Equal Opportunity Programs immediately. You must also report
any changes in your name or permanent address to Equal Opportunity Programs in a timely
fashion. Failure to comply with these provisions will result in forfeiture of the award and the
possibility of having to repay an amount received from the program.
In order to receive your fellowship check from the Office of Equal Opportunity Programs, you will
be required to show your current schedule of courses, as well as your grade report from the
previous semester.
An appointed committee comprised of Directors from the following areas will determine
nominees: Graduate Studies, Financial Aid and Multicultural Affairs. Appeals to the selection
process may be forwarded through the Office of Equal Opportunity Programs.
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FLORIDA ATLANTIC UNIVERSITY
“DELORES A. AUZENNE FELLOWSHIP”
2005-2006 APPLICATION FOR GRADUATE STUDY
Please TYPE or PRINT with black ink. Write “N/A” in sections not applicable.
1.
NAME _________________________________________________________________________
Last
2.
Middle
PERMANENT ADDRESS _______________________________________________________________
Street
3.
First
Apt. #
City
State
Zip
TELEPHONE: (Day)___________________________ (Evening)______________________________
(Area code)
(Area code)
4.
PLACE OF EMPLOYMENT ___________________________________________________________
5.
RACE ___________ SEX ______ SOCIAL SECURITY # ____________-_________-____________
6.
Have you ever been accepted for graduate study at FAU as a regular, full-time degree-seeking
student?
_____ Yes _____ No
7.
a. DEGREE SOUGHT _________________________
c. DATE OF ADMISSION ________________
b. DEPT/COLLEGE _________________________
d. STATUS, IF NOT YET ADMITTED ________
ARE YOU CURRENTLY ENROLLED AT FAU? ______ Yes
______ No
If not, what was your last term of enrollment? ______________________/_______________
Semester
Year
8.
NUMBER OF SEMESTER HOURS COMPLETED TOWARD DEGREE SOUGHT
NUMBER OF SEMESTER HOURS IN PROGRESS
_______
_______
9.
TOTAL NUMBER OF CREDITS REQUIRED FOR DEGREE SOUGHT
_______
10.
EXPECTED DATE OF GRADUATION _____ /_____ /______
11.
Cumulative grade point :
12.
____________________________________________________________________________________
_____________________
Undergraduate Institution
________________________________________________________________________
Graduate Institution
13.
Grant support is requested for the following term(s): (Check all that apply.)
FALL 2005 _____
SPRING 2006 _____
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14.
Type and date(s) of previous SUS grant support: ____________________________________
____________________________________________________________________________
15.
Are you receiving other forms of Financial Aid from FAU or other state university system sources?
____ No
_____ Yes
If yes, please specify. ____________________________________
______________________________________________________________________________
16.
ARE YOU A CITIZEN OF THE UNITED STATES?
_____ I am a U.S. Citizen
_____ I am a permanent resident (Attach a copy of your permanent resident card)
_____ I am a non-U.S. Citizen or nonpermanent resident alien and possess the following category
of visa (Check the one which applies.)*
_____ B _____ C _____ D _____ F _____ J _____ L _____ M
* If you checked any of the categories above, you are not eligible for this Fellowship.
17.
ARE YOU A RESIDENT OF FLORIDA? _____ Yes
18.
READ CAREFULLY: This certifies that I have been informed of the policies and procedures
governing this award including my responsibility to notify the university Equal Opportunity
Programs (EOP) Director upon,
a.
b.
c.
_____ No
completion of the approved program of study;
termination of enrollment in an approved program of study; or
change of name, permanent address, telephone number or school.
I understand that continued eligibility for the fellowship is based on maintaining satisfactory academic
progress each semester. In the event that I am awarded the fellowship, if I receive an incomplete
grade, it is my responsibility to immediately notify the university EOP Director, in writing,
regarding my plans to have the incomplete grade removed. Further, it is my responsibility to
provide the EOP Director with timely verification that the incomplete grade has been
removed and documentation of the final grade. I understand that failure to finish incomplete
coursework in a timely manner or otherwise maintain satisfactory academic progress in
either the fall or spring semesters may jeopardize my award in subsequent semesters.
If I fall below the required full-time status without valid explanation, I will forfeit the Fellowship and must
reimburse the university for the full amount of the award. Finally, I understand that failure to comply
with the above will result in a hold being placed on my records which will prevent me from matriculating
in the future.
__________________________________________________
Signature
Date
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