Sample of Dissertation Fellowship Application Cover Sheet
To fill out form please download the MS Word document (11KB)


Name:     ______________  

Department:     ______________  

UO ID:    _______           Phone:    ____________   

E-mail address:    _____________   

Title of Dissertation:    ________   

Abstract (not to exceed 200 words):   ________   

Name of Dissertation Advisor:   ________   

Preferred Fellowship Term for 2009-10      Fall 2009   ______

                                                          Winter 2010   ______

Do you have an accepted proposal for your dissertation?

Yes   ___     No   ___

Will you have a GTF appointment, a training grant, or other support during the term of the Fellowship?

Yes   ___     No   ___

If your research involves human subjects, animal use and care, or biological safety, have you received approval from the UO?

Yes   ___     No   ___