Dorothy
Marchus Senesh Fellowships APPLICATION FOR DOROTHY M. SENESH GRADUATE FELLOWSHIP
Background Information
Name________________________________________________________________________
Last Name (Family Name) First Name Middle
Address_______________________________________________________________________ ____________________________________________________________________________
Birthdate________________________Birthplace_______________________________________
Country of Citizenship_______________________________________________________________
Home Telephone_________________ Work Telephone__________________ Fax______________
Email Address____________________________
What degree program are you in/or entering?____________________________________________
Name of University/Institute (currently enrolled in or that you plan to enroll
in)__________________________________________________
Department of Study_________________________
Your Major_________________________________
Special Field or Emphasis___________________________________________________________
What are the dates of your school term(s)?______________________________________________
When did you begin graduate study?
Or when will you begin graduate study?_____________________________________________
Please attach a copy of official letter of acceptance into your graduate program.
University or College attended for Undergraduate (post-secondary) work.
Name
City
Country
Dates
Degree
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Finances
List your estimated expenses for one school year (a calendar year).
Expenses
Housing________________________
Tuition_________________________
Books__________________________
Transportation___________________
Food___________________________
Clothing________________________
Other___________________________
Total___________________________
What is the currency used in the above estimate?____________________________________________
Note: You must complete this section in order for your application to be considered complete.
List any scholarships or grants awarded for your graduate work.
Grantor of Scholarship Amount Time Period
______________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Since the Fellowship can only cover a part of your expenses, how do you anticipate covering the rest of your financial expenses?
References
List the names and addresses of three (3) references you have asked to write a letter of recommendation on your behalf. Be sure to select references who are in a position to comment competently on your abilities, not only in terms of graduate study, but also in terms of application of your studies to the situation in your own country. Have each reference send their letter of recommendation directly to Dr. Johnston at the address listed below, or have them email it to the email address below. Please do not include letters of recommendation with your application.
Name
Address City Country
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Graduate Study and Career Plans; Past Experience
(Briefly discuss each item below, use only the space provided)
How would you specifically focus the two-year fellowship program? Describe
your proposed area of
concentration, possible thesis topic, and so on.
List your work experience from completion of secondary school to the present.
Describe any professional and volunteer experience in the area of peace, conflict resolution, development, and other areas that you see as related to peace and development.
Describe any other experience that might be applicable to your chosen field.
What are your future career plans and how do you see graduate work assisting you in this?
List professional societies, civic, and other organizations of which you are a member, and positions held, if any.
Indicate your native tongue. List other languages you read and/or speak and indicate degree of proficiency (poor, good, proficient).
Applicant’s Signature____________________________________ Date_________________
Mail this application to: Dr. Linda M. Johnston, Ph.D., President of the IPRA Foundation and Director of the Conflict Management Program, Kennesaw State University, 1000 Chastain Road, #2205, Social Science Building #22, Room 5034, Kennesaw, GA 30144-5591.
Note: Deadline for receipt of application is January 15, 2010. Award will be announced by February 15, 2010. If you have questions regarding this application, please email Dr. Johnston at or phone: 678.797.2233.