Dwight David Eisenhower Transportation Fellowship Program2011 Eisenhower Graduate Fellowship

Dwight David Eisenhower Transportation Fellowship Program2011 Eisenhower Graduate Fellowship

Application Form - Part 1Must be typed

Name (Last, First, MI) / For Official Use Only:
Current Address / Telephone No.:
E-mail Address:
Alt. Number:
Permanent Address / Telephone No.:
Check the box which represents your status as of 9/1/2011:
___ Masters Degree
___ Doctorate Degree
Year of Study ______
(i.e. . 1st,2nd )
Current Grade Point Average ______/ RACE (optional)
__ American Indian
__ Alaska Native (Aleut or Eskimo)
__ Asian
__ African American/Black
__ Native Hawaiian/Other Pacific Islander
__ White
__ Other
ETHNICITY (optional)
__ Hispanic or Latino
__ Not Hispanic or Latino
__ Hispanic or Latino in Puerto Rico
__ Not Hispanic or Latino in Puerto Rico
Gender:
__ Male
__ Female
U.S. Citizen
__ Yes
__ No - If no, please attach a certified copy of your I-20 or I-551 ID issued by the I.N.S.
College or University (Current or Pending) / Academic Dept.
Name, Title and Address of Faculty Advisor / Telephone No.:
E-mail Address:
Applicant's Major / Applicant's Field of Study
Date / Signature of Applicant (Required)
Date / Signature of Faculty Advisor (Required)

Application Form - Part 2Must be typed

Colleges/Universities
Attended / Dates
Attended / Degrees
Earned / Date
Awarded
Employer (most recent first) / Address / Name of Supervisor
and Telephone No. / Dates of
Employment
From:
To:
From:
To:
List Academic Honors, Scholarships, Offices Held in Student /Professional Organizations, etc.
Community Activities/Organizations:
Experience in Transportation Education Programs
__ ENO Fellow Year _____
__ UTC Award Year _____
University Transportation Centers
__ DDE Fellowship Year _____
Dwight David Eisenhower Transportation Fellowship / __ STIPDG Year _____
Summer Transportation Intern Program for Diverse Groups
__ NSTI Year _____
National Summer Transportation Institute
__ Other Year _____
Name ______

Application Form - Part 3Must be typed

Proposed Plan of Graduate Study
Please provide a summary of how your plan of study will impact and enhance the field of transportation and what role transportation takes in your professional goals. Incorporate educational, personal and work experiences, accomplishments, volunteer activities and/or events that support your plan of study. Limit 2 pages.
/

2011 DDETFP Applicant Checklist

(Keep This Page for Your Records)
Dear Applicant:
This letter is provided in an effort to ensure that all information is submitted in a timely manner. Incomplete packages will NOT be considered. Please pay attention to all deadlines and information.
Prior to sending your packet to Universities and Grants Programs, 1310 North Courthouse Road,Suite 300, Arlington, VA 22201, ensure that you have reviewed your application thoroughly and are confident that all materials are enclosed.
If you would like confirmation of delivery provide a Postage Paid Postcard w/ your return address.
Application Items
- Citizenship / _____
- 4 Copies of Application Packet / _____
- Contact Information / _____
Phone Number / _____
E-mail / _____
Faculty Advisor Signature / _____
Applicant Signature / _____
OfficialUniversity Transcripts / _____
Letters of Recommendations
(maximum 4) / _____
Resume/CV / _____
Full Academic Year Remaining (See Eligibility Requirements) _____
** Applications and all supporting materials are due by 5:00p.m. February 11, 2011 **
NO Exception!!
Comments:
______
______
______

This page last modified on October 1, 2010