Stanford Graduate Fellowships

							              Stanford Graduate Fellowships in Science & Engineering
                            BANKING REQUEST FORM
  To be completed by Fellows who wish to defer quarter(s) of support for later use. Quarters of support
           may be banked provided all can be used in the first five years of graduate study.

FELLOW:
 (STUDENT ID)                               QUARTER(S) of SGF SUPPORT TO BANK
                                            Academic Year               Quarter(s)

 (LAST NAME)                                (FIRST NAME)                                     (MIDDLE NAME)

 (DEPARTMENT)                               (E-MAIL ACCOUNT)


 ADVISOR:
 (LAST NAME, FIRST NAME)               (DEPARTMENT)                           (E-MAIL ACCOUNT)



REASON FOR REQUEST:
No form is required if the reason to defer SGF support is a teaching appointment, use of a training grant,
or up to 4 qtrs. of an approved leave of absence. Banking will be approved when those actions are
entered in the student’s academic record. Certification is needed to request banking for all other reasons.


 RA           INTERN               INTERN AND/OR PRACTICAL TRAINING

 OTHER (PLEASE DESCRIBE):




CERTIFICATION:
Briefly describe how the activity will contribute to Ph.D. degree progress.




 ____________________________________                      ____________________________________
 Fellow’s Signature / Date                                 Advisor’s Signature / Date




 Send to:              Stefanie Moss, Fellowship & Program Coordinator
                       Building 310, ID Mail Code: 2102
                       E-mail: stefmoss@stanford.edu
                       Fax: 723-7237; Phone: 736-9796