2015 2016 Delores A. Auzenne Fellowship Application for Graduate Studies DESCRIPTION: The Delores A. Auzenne Fellowship is designed to assist Florida A&M University in increasing the matriculation of minority graduate students in disciplines in which there is underrepresentation, e.g. in STEM disciplines. Under this program, graduate students may receive awards up to $5,000 ($2,500 for the fall and/or spring semester) per year. New or returning students may apply each year. Awards will not be made to the same Delores Auzenne Fellows for more than two academic years (4 semesters; fall and spring) for master s students and two academic years (4 semesters) for doctoral students. Students may apply each year. Awards are contingent on the availability of funds. Eligibility Requirements In order to qualify for a Delores A. Auzenne Fellowship, a student must meet the following criteria: 1. Has been accepted as degree seeking into a graduate (master s or doctoral) program at Florida A&M University in which minority graduate students are disproportionately underrepresented; 2. Has demonstrated initiative in pursuing his or her educational goal; 3. Possesses the qualifications to assure satisfactory progress toward his or her future educational goal; 4. Is either a citizen or a permanent resident (a copy of your card must be submitted) of the United States, or; Has been classified as a Florida resident for tuition purposes for at least one year preceding the award of financial aid (Florida Statute 1009.21) http://www.leg.state.fl.us/statutes/index.cfm?mode=view%20statutes&submenu=1&app_m ode=display_statute&search_string=1009.21&url=1000-1099/1009/sections/1009.21.html ; 5. Does NOT have any other assistantship or fellowship; 6. Is enrolled as a full-time student (9 cr. hr.); and 7. Has submitted a completed application packet (see pages 2-7) and all requested information by the stated deadline. Application Requirements (Please use the forms provided only.) To be considered for the Delores A. Auzenne Fellowship, new applicants should submit the completed applications and the following supporting documents to the address below: 1. One page, typed, double-spaced personal statement (see page 5) with your career objectives and state how this fellowship will assist you to accomplish your goals; 2. A copy of your letter of acceptance; 3. A statement from your academic advisor (see page 7) that includes: a. Total credits required for the degree program; b. Total hours completed; c. Total hours in progress; d. Cumulative GPA, undergraduate and graduate; and e. GRE scores 4. Copies of all transcripts for all post-secondary institutions attended (unofficial copies for current FAMU students); 5. Two current letters of recommendation from professors or current supervisor on the form provided; and 6. A copy of your visa (if you are a non-u.s. citizen).
Application Current Address: E-mail: Phone # Race: Gender: I am a U.S. Citizen or I am a permanent resident alien. (Please attach a copy of your card.) I am a Florida resident for tuition purposes in accordance with FL statutes 1009.21(10)(a) and 1009.21(2). ************** 1. Degree program enrolled in: Master's; Doctoral 2. College: Department: Specific Academic Program: 3. Applicant s Program Sponsor/Graduate Advisor: 4. Cumulative grade point average: a. Graduate: b. Undergraduate: 5. Number of semester credit hours completed toward degree at time of application: 6. Number of semester credit hours in progress: 7. Total number of credits hours required for degree: 8. Expected date of graduation: Semester Year 9. Have you received the Auzenne Fellowship before? Yes; No. If yes, when. 10. List below in chronological order every college or university you have ever attended and the academic degrees you have earned. Name of School Location Dates of Attendance Degrees Earned and Dates 2
(To be TYPED and completed by the Applicant) FINANCIAL AID: List any additional funding that you will be receiving for your studies, including tuition waivers, grants, and/or scholarships for the application year. This Fellowship is being requested for: Fall 2015; Spring 2016; or Both I certify that I have read and understand the conditions for participating in the Delores Auzenne Fellowship program. The information supplied is true, complete, and accurate. By signing this form, I also grant permission pertaining to my financial need, and all supporting application materials to be released by the appropriate university to the Florida Board of Education. If I purposely give false information, I may be subject to a fine, or imprisonment, or both under 837.06. F.S. I further understand that if my application is incomplete and/or late, it will not be reviewed. Applicant Name Signature Date Submit your completed application packet, via Blackboard, on or before April 30, 2015 to: Graduate Studies and Research 469 Tucker Hall Florida A&M University Tallahassee, FL 32312 Newly admitted students (non FAMU students) should mail their completed packet to the above address. Please e-mail any questions to gradstudies@famu.edu or call (850) 599-3505. 3
LETTER OF RECOMMENDATION In what capacity do you the applicant? How long? Based on your knowledge of the applicant, please rank and describe below the applicant s potential as a graduate student. Category Potential for graduate study Recommend strongly Recommend Recommend with reservations Do not recommend Description: Please rank the applicant in the following categories: Category Excellent Above Average Ability to work with others Emotional Stability Leadership potential Initiative Average Below Average Poor Do not know Signature: Date: Title: Date: Institution or Firm: E-mail: Phone 4
(To be TYPED and completed by the Applicant) FINANCIAL AID: List any additional funding that you will be receiving for your studies, including tuition waivers, grants, and/or scholarships for the application year. This Fellowship is being requested for: Fall 2015; Spring 2016; or Both I certify that I have read and understand the conditions for participating in the Delores Auzenne Fellowship program. The information supplied is true, complete, and accurate. By signing this form, I also grant permission pertaining to my financial need, and all supporting application materials to be released by the appropriate university to the Florida Board of Education. NOTE: If you purposely give false information, you may be subject to a fine, or imprisonment, or both under 837.06. F.S. I further understand that if my application is incomplete and/or late, it will not be reviewed. Applicant Name Signature Date Submit your completed application packet on or before April 30, 2015 to: Graduate Studies and Research 469 Tucker Hall Florida A&M University Tallahassee, FL 32312 E-mail to gradstudies@famu.edu 5
(To be TYPED and completed by the Applicant) PERSONAL STATEMENT (Do not exceed 500 words.) Below, please explain your reasons for pursuing graduate study at Florida A&M University and your career objectives. Also, please state how this fellowship will assist you to accomplish your goals. Include any internships, research, publications, presentations and service activities that you have conducted that relate to your career goals. Applicant s Signature Date 6
(To be TYPED and completed by the Graduate Advisor and Dean, School/College) SCHOOL/COLLEGE DEGREE PROGRAM: ************ To the Advisor: The above-named student is applying for a 2015-2016 Delores Auzenne Fellowship. Please verify the following information on this applicant: 1. Number of semester credit hours completed toward degree at time of application: 2. Number of semester credit hours in progress: 3. Total number of credits hours required for degree: 4. Expected date of graduation: Semester Year 5. a. Undergraduate GPA: b. Graduate GPA: c. GRE Scores: Verbal; Quantitative (FAMU students could submit an unofficial copy of your scores.) I verify that the above information is accurate. Name of Graduate Advisor Signature Date Name of School/College Dean Signature Date 7