Application

Outstanding Graduate Student Award

Application Due: March 15, 2013

Period of Accomplishments: January 1, 2012 – December 31, 2012

Degree sought: M.S. ___ PhD ___

Applicant’s Name: - Please type applicant's name here -

Applicant’s mailing address:

Email:

Phone:

Applicant’sAdvisor or Supervisor: - Please type name here -

Signature of Applicant: ______Date: ______

Applicant's Address: - Please type applicant's current address here -

Applicant's Telephone No.: - Please type applicant's daytime telephone number here -

Date received: ______

Received by: ______

Supporting Documentation

Grade Point Average (4.0 scale):

  • In the text box below, please enteroverall graduate grade point average (4.0 scale).
  • 3.50 – 3.65 = 1 point
  • 3.66 – 3.75 = 2 points
  • 3.76 – 3.85 = 3 points
  • 3.86 – 4.00 = 4 points

GPA = None

Extracurricular Activities: (Maximum of 4 points)

  • In the text box below, please list affiliations with professional/student organizations, offices held in professional organizations, offices in Student Government Association, and community service. The text box will expand as you type.

None

Personal Statement: (Maximum of 4 points)

  • Brief statement from applicant discussing current involvement in the profession and future contributions.

Letters of Reference: (Maximum of 4 points)

  • This award application package must include a minimum of three, and not more than five, letters of reference from individuals who can evaluate the applicant’s research and/or service efforts.

In the box at the left, please enter the number of letters included in this award application packet.
Please provide names and contact information in the text box below. The text box will expand as you type.
- Please enter the name, mailing address, telephone, and e-mail address of each reference here -

Presentations: (Maximum of 4 points)

  • In the text box below, please type a complete reference [author(s), year of presentation, title, meeting organization, meeting location, meeting date(s)] for each presentation to be evaluated for this application packet. The text box will expand as you type.
  • For each presentation, you must also include and clearly indicate the following information:
  • The type of meeting (professional or non-professional; international, national, or local)
  • Whether the presentation was oral or poster
  • Whether the presentation was refereed or non-refereed
  • Whether the presentation was on-campus or off-campus

None

Awards: (Maximum of 4 points)

  • In the text box below, please type a list of awards received during the period of accomplishments. The text box will expand as you type.
  • For each award, you must include the following information:
  • The name of the award
  • The awarding organization
  • The date of the award
  • The type of award (professional or non-professional; international, national, or local)

None

Publications: (Maximum of 4 points)

  • A reprint or copy of each publication must be included as a supporting document in this application packet.
  • In the text box under the appropriate category below, please type a complete reference [author(s), year of publication, title, publisher] for each publication supporting document included in this application packet. The text boxes will expand as you type.
  • Refereed Publications:

None

  • Non-Refereed Publications:

None

  • Magazine Articles:

None

  • Newspaper Articles:

None

  • Abstracts:

None

  • Proceedings:

None

  • Books:

None

  • Book Chapters:

None

  • Bulletins:

None

  • Other:

None

Submit application form and supporting materials electronically to:

Sue Ballard de Ruiz