The Doris Duke Conservation Fellows Program

Fellowship Application

2010-2012

1. Name

LAST FIRST MIDDLE

2. Present Address

STREET CITY STATE ZIP CODE

3. Telephone: ( ) Email Address:

4. Country of Citizenship: □ □

U.S. OTHER (please specify)

5. Intended Specialization:

6. Do you plan to pursue an internship related to conservation? Yes □ No □

If so, what type of internships and locations are you exploring?

7. Do you plan to pursue a career in environmental conservation? Yes □ No □

If so, what type of jobs do you hope to pursue?

8. Education Dates Degree(s) Received Grade Point Average

Institutions attended above A=4.0 scale

high school level. List most recent first from to

◦ / / ◦ ◦

◦ / / ◦ ◦

◦ / / ◦ ◦

9. Fellowships, Honors, Publications, Exhibitions, etc. applicable to environmental conservation:

10. To get a better understanding of our pool of applicants please indicate your ethnic origin:

11. Please list your Fall 2010 quarter classes (the number and title):

12. Please submit a current Resume

13. Please answer the following in two-three paragraphs per question (single space, 10 font minimum):

1. Describe your short and long term career goals as they relate to environmental conservation. How will the world be different in 25 years as a result of your conservation leadership?

2. How have your passion for and insights about environmental conservation been shaped by your educational, work, and personal experiences? What unique insights do you bring to solving environmental challenges?

3. Describe a specific example of a situation in which you demonstrated leadership (not necessarily conservation related). Pay particular attention to how you led, what inspired you to lead, and what you learned from the experience.

4. In 350 words or less, describe a current conservation problem that you think is especially significant and compelling. Summarize how you would approach solving this problem.

14. I understand and consent that the Bren School Academic Affairs Office may use all documents submitted for admission into the Bren School for fellowship consideration.

Signature Date

Please submit all materials to Corlei Prieto, no later than noon by January 3rd.

If you plan to be out of town, you may send your hard copy application via mail to:

Attn: Corlei Prieto

University of California

2400 Bren Hall, Santa Barbara 93106-5131