NIEHS/UC Davis Superfund Research Program
Fellowship and Nonresident Tuition Waiver Application Questionnaire
Instructions: Complete the following and include with your application. Please print clearly.
Note: You must file a Free Application for Federal Student Aid (FAFSA) in order to determine work study eligibility for
a fellowship. If you are applying for a work study fellowship and have not filed a FAFSA, you should do so as soon as
possible. You may file a FAFSA via the web at http://www.fafsa.ed.gov. If you do not have access to the web, contact
the UC Davis Financial Aid Office at 530-752-9246 or visit their office in Dutton Hall.
Name
Home Address
City, State, Zip
Home Telephone
Whose lab do you work in/will you be working in?
Graduate Group
What year of study are you in currently?
Campus Address
Campus Telephone
E-mail Address
Yes
No
Have you filed a Free Application for Federal Student Aid (FAFSA) form?
(THIS IS REQUIRED TO DETERMINE WORK STUDY ELIGIBILITY.)
Are you a U.S. citizen?
Are you a permanent resident?
Are you a California resident?
Are you an international student?
Have you advanced to candidacy?
Are you subject to nonresident tuition?
If yes, do you pay the full fee or the reduced fee?
I am applying for:
work study fellowship
nonresident tuition waiver
both
Full
Reduced (circle one)