Personal Information
Full Name:Last / First / M.I.
Address:
Street Address / Apartment/Unit #
City / State / ZIP Code
E-mail Address:
Social Security Number: / No social security number >
US Citizen? / yes no / Preferred Phone: / ()
Educational Information
List the educational institutions that you have attended, are attending, and at which you wish to pursue your education with the CaGIS scholarship.Name of institution and location / Degree obtained or expected (indicate date) / Years of attendance / Major field of study
Current faculty advisor or supervisor: / Contact information of supervisor (e-mail and/or phone):
CaGIS Membership Number (if a member):
In addition, prepare a one-page (400 word) statement describing your existing and potential contributions to Geographic Information Science, and how your work relates to the mission of the Cartography and Geographic Information Society. E-mail this application form, your statement, and a digital version of your transcript to Fritz Kessler, CaGIS Student Activities Coordinator, at . In your e-mail, copy and paste the following statement:
I certify that the information given in this application is true and accurate. I further certify that if for any reason subsequent to receiving a fellowship or scholarship award, I elect to substantially alter my proposed study plan, I will immediately inform CaGIS, and if requested, I will return the money paid to me.
Please also have a professor or supervisor familiar with your scholarly work e-mail a letter of reference. Recall only completed applications (including this form, the letter of reference, and a transcript) received by January 18, 2015 no later than 5:00 p.m. CST will be considered.
If necessary, paper documents can be sent to:
CaGIS Scholarship, c/o Fritz Kessler, Department of Geography, 230 Gunter Hall, Frostburg State University, Frostburg, MD 21532 All paper documents must also be received by the deadline above.