APPLICATION FORM
2016-2017 Scholarships and Fellowships
Asian Studies Center
University of Pittsburgh
INSTRUCTIONS: Please type or print. ALL applicants must submit completed application form,
official transcripts, letters of recommendation, and a written statement (five page maximum) summarizing
academic goals, career objectives, research interests and plans for use of the award. Applicants for
GRADUATE fellowships must also submit a current CV, GRE scores and, if applicable, TOEFL scores.
Submit supplemental application forms where indicated. Note: Provide all information required by this
form, but where Special Instructions differ from general application requirements, follow the Special
Instructions. Send all materials to: Asian Studies Center, 4400 Wesley W. Posvar Hall, University of
Pittsburgh, PA 15260.
APPLICATION DEADLINE: Monday, February 1, 2016.
1. Your Name: Mr./Ms.:
First Name
Family Name
_________________________________________________________________________
2. PeopleSoft ID# :__________________________________________________________________
3. IF YOU ARE A NEW STUDENT APPLYING TO THE UNIVERSITY OF PITTSBURGH,
please indicate the degree (MA, PhD) you seek and the department(s) or program(s) to which you are
applying:
Degree
Department(s) or program(s)
4. IF YOU ARE CURRENTLY ENROLLED AT THE UNIVERSITY OF PITTSBURGH, please
indicate:
a) Major department: __________________________________________________________
b) Degree sought: ____________________________________________________________
c) Expected graduation date: ____________________________________________________
d) Advisor’s name & e-mail: ________________________________________________
5. Pittsburgh Address: ___________________________
6. Pittsburgh Tel.: ___________________
______________________________________________ 7. Campus Tel.: _____________________
8. Permanent Address: ___________________________ 9. Permanent Tel.: ___________________
______________________________________________ 10. E-Mail: _________________________
11. Have you been on the University of Pittsburgh payroll at any time during the last 12 months?
[ ] Yes
[ ] No
12. Citizenship:________________________________ 13. Native Language:_________________
14. If you are not a U.S. citizen, do you have permanent resident status? [ ] Yes [ ] No
15. GRE Scores
[ ] Attached
16. TOEFL Score: [ ] Attached
[ ] Will Send
[ ] Will Send
17. Tuition Status: [ ] In-State
[ ] Out of state
18. Are you currently enrolled in the Asian Studies Certificate program?
[ ] Yes
[ ] No
(If not, contact the Asian Studies Center office for information and an application form.)
19. Asian studies courses enrolled in during Fall Term 2015 (list)
_________________________________________________________________________________
_________________________________________________________________________________
20. Education (including University of Pittsburgh), beginning with most recent:
Institution
Major
Years Attended
Degree
GPA
a. _______________________________________________________________________________
b. _______________________________________________________________________________
c. _______________________________________________________________________________
d. _______________________________________________________________________________
21. Foreign Language Proficiency
Language
Institution
Years Studied
a. _______________________________________________________________________________
b. _______________________________________________________________________________
c. _______________________________________________________________________________
d. _______________________________________________________________________________
22. Previous residence outside U.S. (list countries and dates)
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
23. Check the award(s) below that you wish to apply for (you may check more than one):
Chinese Studies Awards
I. ______ Chancellor’s Graduate Fellowships
II. ______ Chinese Studies Tuition Remission Scholarships
III. ______ Chinese Summer Language Study Scholarship
Japanese Studies Awards
IV. ___Japanese Studies Undergraduate Scholarship
V. ____Study-in-Japan Scholarship
VI. ____Japanese Summer Language Study Scholarship
Special Instructions: For Graduate Students only: Applicants must submit a) a brief statement of
relevance of language study to your graduate study, and b) one letter of support from applicant’s
advisor. Undergraduates: Follow general instructions.
VII. ____Japan Studies Doctoral Research Grants
Special Instructions: Applicants must submit a) a detailed research project proposal (3-page maximum), b)
a research budget, c) a letter of support from applicant’s dissertation advisor.
VIII. ____Mitsubishi Foundation Graduate Fellowship in
Japanese Studies
Special Instructions: 1 of the 3 required recommendation letters must be from the applicant’s major
advisor. Students cannot hold a Mitsubishi Fellowship concurrent with another grant.
Korean Studies Awards
IX. ______ Korean Studies Tuition Remission Scholarship
X. _____ Korean Studies Graduate Student Conference Travel Grant
IndoPacific Council Awards
XII. _____ INPAC (IndoPacific Council) Studies Tuition Remission Scholarship
24. Term(s) for which funding is sought: ________________________________________________
25. Are you applying for other financial aid? ______ Yes ______ No
If yes, specify: ____________________________________________________________________
26. Estimated tuition requested for 2016-2017: ___________________________________________
27. I have requested recommendation letters from the following persons:
(Notes:
1. Do not limit recommendations to language faculty alone. Follow Special Instructions if they
are indicated for your grant application category.
2. Undergraduate applicants need only submit two letters: one from a language faculty, and one
from another reference. Graduate students should please submit three. )
Name Title
Institution
a. __________________________________________________________________________________
b. __________________________________________________________________________________
c. __________________________________________________________________________________
28. The undersigned attests that the information contained in this application is true and complete:
_________________________________ _______________________________
Signature of Applicant
Date