Post-Doctoral Resident Fellowships Application Form

Name:

Position/Title:

Office Address:

City/State/Zip:

Phone:

Fax:

E-mail:

Home Address:

City/State/Zip:

Phone:

Date of Birth:

Place of Birth:

Citizenship:

Country of Permanent Residence:

Social Security #:

Passport # (non-US applicants):

Number of Dependents who will accompany scholar : ________

Preferred dates for Resident Fellowship:

Choose one:

Fall (Sept. – Dec.) ____Year 200 ____

Spring (Jan. – May) ____Year 200 ____

Proposed Research Title :

Project Summary (100 words, in English if possible):

 
 
 
 
 
 
AFTER APPLICATION IS COMPLETED, PRINT IT
 
Please submit the following:
 
1. This application form 
2. A description of the proposed research of about 2,500 words 
3. Samples of publications, if available (non-returnable) 
4. Curriculum Vitae 
5. Letters of reference from three persons familiar with applicant's work. 
* These letters should be sent directly to the Center
 
Send completed applications to: 
 
Latin American Studies Center
(Attn: Post-Doctoral Fellowships) 
0128-B Holzapfel 
University of Maryland 
College Park, MD 20742