GRADUATE SCHOOL DOCTORAL DISSERTATION AWARD APPLICATION FORM

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READ THESE INSTRUCTIONS BEFORE FILLING IN THE APPLICATION Purpose The University of Florida (UF) Graduate School Doctoral Dissertation Award is a competitive, need based award program to provide final stage funding over an approximate period of 4-6 months for UF PhD candidates who have exhausted all other avenues of support. This support will allow recipients the time and resources to focus exclusively on their dissertation through defense, final clearance, and graduation. This award is for PhD candidates who have exhausted all other sources of maintainable support. All students can apply though non-stem students will have preference. Eligibility To be eligible for this award: 1. You must be a UF graduate student. 2. You must have successfully defended your dissertation proposal before this award s application deadline. 3. You must be admitted to candidacy before this award s application deadline. 4. You must present a copy of your current term registration to show that you are properly enrolled and in good standing for the semester during which you are applying for the award. 5. You cannot be on any assistantship, fellowship or other award during the award period. 6. You cannot be employed by the University of Florida during the award period. 7. You cannot be a past or present recipient of the Delores Auzenne Dissertation Award or Graduate School Doctoral Dissertation Award. 8. You must submit your completed application package with all appropriate signatures by the deadline posted for this application cycle. Incomplete applications will not be accepted. 9. You must meet all other criteria established by the program. Terms and Conditions Term of award: Application deadline: Amount of award: Payment conditions: Spring 2018, Spring + Summer C 2018 or Summer C 2018 Friday, October 20, 2017, at 5 p.m. Up to $15,000 + in-state tuition and fees Option A: Spring 2018: $9,000 + three credits of in-state tuition and fees Option B: Spring + Summer C 2018: $15,000 + in-state tuition and fees for spring (three credits) and summer (two credits) Option C: Summer C 2018: $6,000 + two credits of in-state tuition and fees To receive each scheduled payment, your advisor must provide documentation about your good standing in your program and progress toward graduation. For the final payment, you must have a degree application on file for your semester of intended graduation. Please note: Non-Florida residents are responsible for the remaining out-of-state portion of their tuition. Academic units are permitted to contribute toward the difference in out-of-state tuition and fees via their scholarship process. Eligible students are encouraged to apply for Florida residency reclassification at the UF Office of the Registrar by clicking on this link to its website: Residency. Recipients are responsible for the cost of health insurance. Students are urged to consult UF Student Financial Services to understand the impact of minimum enrollment on their financial aid. Checklist Please be sure your application package is one single PDF file, for submission by e-mail. The package must include: 1. Complete application form with all signatures. 2. Proof of enrollment for current term. 3. Summary of your dissertation proposal (no more than five pages plus one page for references, double-spaced in 11point type with one-inch margins). 1

4. Academic progress statement and timeline of completion to graduation, written by the applicant and signed off by the dissertation committee chair. 5. Letter of support from supervisory committee chair. 6. E-mails of support from all supervisory committee members. 7. Curriculum vitae. Submit a PDF copy of your dissertation to date, in the UF dissertation format, as a separate file. Submission By the deadline posted for this application cycle, please e-mail your single PDF application package and a PDF copy of your dissertation to date to UF Graduate School Awards at gradawards@aa.ufl.edu. Notification All applicants will be notified of the decisions made on their applications by e-mail, sent to their GatorLink e-mail addresses. Questions? Please e-mail any questions you have to UF Graduate School Awards at gradawards@aa.ufl.edu. Determine Your Eligibility Before filling out this application, answer yes or no to these statements to see if you meet the minimum criteria to be eligible for this award. 1. I am a UF PhD student. 2. I successfully defended my dissertation proposal by the application deadline. 3. I have been admitted to candidacy by the application deadline. 4. I am registered and properly enrolled for the current semester, during which I am applying for the award.* *If you answer Yes to question 4, attach a copy of your current term enrollment. If you answer No, attach a written explanation from your supervisory committee chair, cosigned by your department chair or graduate coordinator, affirming that you are in good standing academically, though you are not currently enrolled. If you answer yes to Items 5, 6 and 7, you are not eligible to apply for this award. 5. I have accepted other assistantships, fellowships or awards for the term of this award. 6. I will be a UF employee during the term of this award. 7. I have received the Delores Auzenne Dissertation Award or the Graduate School Doctoral Dissertation Award in the past. 2

Personal Profile Name UFID Number Current Address Telephone Number GatorLink E-mail Address Citizenship Ethnic Origin Academic Information Dissertation Title Successful dissertation proposal defense date Admission to candidacy date PhD major on your GIMS record Supervisory committee chair name Supervisory committee chair's home department Anticipated date of final defense and dissertation completion Total credit hours planned for term of this award Period for which you are applying for this award Option A Spring 2018 $9,000 + three credit hours of in-state tuition and fees Option B Spring + Summer C 2018 $15,000 + in-state tuition and fees for spring (three credits) and summer (two credits) Option C Summer C 2018 $6,000 + two credit hours of in-state tuition and fees 3

Anticipated PhD Funding On this page, list any funding you applied for or will receive during the term of this award. Include travel funds, tuition waivers, internal or external grants, scholarships, outside employment, gifts, etc. For each entry, answer these questions in list form: What is the expected semester and year for this funding? What is the type or purpose of the funding (teaching assistantship, research assistantship, fellowship, scholarship, grant, travel funding, research funding, etc.)? What is the source of the funding, the name of the funding and the name of the entity providing the funding? What is the amount of the funding in US dollars ($)? Does this funding come with a tuition waiver? (Yes or No) What is the status of your request for this funding applied or received? What is the expected date of notification for your application for this funding? Attach additional sheets, if needed. 4

Current and Past PhD Funding On this page, list all funding you received since starting your PhD degree program. Include university-funded assistantships and fellowships as well as external funding. For each entry, answer these questions in list form: What was/is the semester and year for this funding? What was/is the type or purpose of the funding (teaching assistantship, research assistantship, fellowship, scholarship, grant, travel funding, research funding, etc.)? What was/is the source of the funding, the name of the funding and the name of the entity providing the funding? What was/is the amount of the funding in US dollars ($)? Did/Does this funding come with a tuition waiver? (Yes or No) Attach additional sheets, if needed. 5

Applicant By signing and submitting this application, I certify the following: I will not receive any other funding during the award period. I will be responsible for paying the out-of-state portion of tuition. I will be responsible for paying for the health insurance. I will be responsible for obtaining all signatures required on this form prior to the deadline. I have read and understand the conditions for participation in this program. The information I supplied on this application is true, complete and correct. I understand that this application will be disqualified if any portion of it is incomplete. I give permission for information pertaining to my application, plus all supporting materials, to be released by the appropriate organization to the University of Florida Graduate School. I am aware that if I purposely give false information, I may be subject to fine, imprisonment or both under Florida Statute 837.06. Supervisory Committee Chair/Department/College s By signing and submitting this application, I certify the following: The applicant meets the eligibility criteria for this award. The applicant has been admitted to candidacy. The applicant has successfully defended his/her dissertation proposal. The applicant is actively writing his/her dissertation. The applicant is in good academic standing with the university and his/her academic unit. The applicant is on track to graduate at the end of the term of this award. The applicant has exhausted all departmental funding. I agree to provide the applicant with appropriate academic unit, faculty and mentor resources to conduct full-time dissertation work. Supervisory Committee Chair Department Chair/School Director College Dean 6