UNIVERSITY OF MINNESOTA
Graduate School Fellowship Office APPLICATION FOR 2013-14
314 Johnston Hall HAROLD LEONARD MEMORIAL FILM STUDY FELLOWSHIP
Please Type Deadline: 12 noon, November 1, 2012
Please check box: Name: Last, First, Middle Student I.D. Number
Email Address: Telephone No.
Undergraduate Institution(s) Major Degree Earned Year Cumulative
Graduate Institution from which post- Major Degree Earned Year Cumulative
baccalaureate degree was earned (if any) GPA
Date of Entry into UM Graduate School Major Cumulative
Degree Sought Proposed Graduation Date (Semester & Year) Date Prelims Passed (or approximate date to
(Working) Thesis or Research Title:
Does the research involve Animal or Human Subjects? Yes No
If yes, provide date, and attach documentation of approval to this application:
List other fellowships, scholarships, grants, or awards for which you are applying or plan to apply.
RECOMMENDATIONS Two letters of recommendation are required. Letters should be submitted to the Fellowship Office in
314 Johnston Hall by the competition deadline, or by email to firstname.lastname@example.org.
Name and department of recommenders are:
The applicant may voluntarily waive the right to inspect letters of recommendation for financial support, thus assuring
the recommender that the letter will remain confidential. The applicant may decline to sign the waiver.
I voluntarily waive the right to inspect the confidential letter of recommendation.
Applicant Signature_____ _____________________Date_____ ________
I affirm that the information provided in this application is complete and accurate to the best of my knowledge.
Applicant Signature___ _______________________Date____ _________
Application and supporting documentation must be submitted electronically, in accordance with the