APPLICATION FOR DOROTHY M. SENESH GRADUATE FELLOWSHIP

This Fellowship is only for women from developing countries who have already been accepted to a graduate program in peace studies from an accredited university. All other applicants will not be considered. Do not apply if you are male, an undergraduate, or not from a developing country.

In order for your application to be considered, please complete all sections in English. There is also a Spanish Application on the website. If you need more space, write all the extra information in one document and attach it to your application email.

Background Information

Name________________________________________________________
               Last Name (Family Name)                                                               First Name                                                                               Middle

Address___________________________________________________

_______________________________________________________

_______________________________________________________

 Birthdate_________________Birthplace________________________

I am female: Yes_____ No _____

Country of Citizenship___________________________________________

Telephone_______________ Alternate Telephone(optional)_________________

Fax (optional)__________________________

Email Address_______________________________________________

Alternate email address (optional)__________________________________

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. This can be in any language and can be a pdf file.

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 (email or post) their letter of recommendation directly to Dr. Johnston at the address listed below. Please do not include letters of recommendation with your application; the letters of recommendation must be sent directly by the recommender.
Note: It is your responsibility to ask your recommenders if they have sent the letters. The Senesh office is not responsible for checking with the recommenders.

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_______________________

By typing your name you affirm that all the information you have entered in this application is true and correct. You may also sign the application, scan it, and email it.

Save this completed application and email or mail it to: Dr. Linda M. Johnston, President of the IPRA Foundation and Executive Director of the Siegel Institute for Leadership, Ethics, and Character, Kennesaw State University, 1000 Chastain Road, Town Point, Room 2400, Maildrop #9114, Kennesaw, GA 30144-5591, .

If the email link does not work on your computer, please use this email address: seneshfellowship(at)iprafoundation(dot)org. Replace the (at) with the "@" symbol and the (dot) with "."

Do not contact the Senesh Fellowship office by phone; we do not accept or respond to phone calls. Please check the IPRA Foundation website for updates: www.iprafoundation.org

Please send all documents, if available, in WORD. Certain documents such as acceptance letters may not be available in WORD, but applications, letters, etc. should be sent in WORD.

Note: Deadline for receipt of application is January 15, 2014. Award will be announced by March 1, 2014. If you have questions regarding this application, please email Dr. Johnston at

If the email link does not work on your computer, please use this email address: seneshfellowship(at)iprafoundation(dot)org. Replace the (at) with the "@" symbol and the (dot) with "."