Summer Institute on Climate Change
FELLOWSHIP APPLICATION 2011
FELLOWSHIP APPLICATION DEADLINE: APRIL 01, 2011
Summer Institute Fellowship selection is based on the information you provide to the questions
below. The deadline for applications is 3:00pm on April 01, 2010. Selection notifications will be
announced no later than April 15, 2010. Unless otherwise noted, the fellowship will cover the
expenses of housing, travel and transportation, all meals, team building activities, and all other
costs of the program.
Applications must be completed, signed, scanned and submitted electronically by emailing
Summer Institute Director, Jenny Dissen (firstname.lastname@example.org). Please include in subject line
‘Fellowship Application 2011.”
Last Name: First:
Employer / Academic Institution:
Title / Position:
Signature of applicant: Date:
In the spaces below, please provide your comments that will assist the Summer Institute Committee in
making a decision for you to receive a fellowship. Please use this form and write your responses
directly in the form.
(list all colleges, universities, research institutions, etc. where you have attended, participated, taught,
etc. List most recent/current first). For professionals, please list all professional societies, organizations
where you have been involved, including extra-curricular activities.
Statement of Interest and Applicant’s Learning Goals
Please describe your interest in, and learning goals for, attending the Summer Institute. Please be
specific about why this Program is of greatest interest to you, and what you hope to achieve from it.
(Limit 300 words)
Statement of Need
Please tell us succinctly your reasons for applying for a Fellowship. Describe your current
employment or research background and interests. Describe to the Summer Institute Committee
why you should be a recipient of the Fellowship. (Limit 500 words)
Thank you for providing this information. Please email your responses to Jenny Dissen, Director of Summer Institute at
email@example.com 828 257 3135.