DOCTORAL FELLOWSHIP APPLICATION
Kappa Omicron Nu Doctoral Fellowships
Five (5) copies of this application form, typed or printed, and all
supporting documents should be postmarked on or before January 15 and submitted to the Kappa Omicron Nu Awards Committee, 4990 Northwind Drive, Suite 140, East Lansing, Michigan 48823-5031
1. ______________________________________________________________
Name (First, Middle Initial, Last)
E-mail address
2. ______________________________________________________________
Present Address (Street)
_____________________________________________( )_________________
(City, State, ZIP Code)
Telephone
3. ______________________________________________________________
Home Address (Street)
_____________________________________________( )_________________
(City, State, ZIP Code)
Telephone
| 4. Degree sought: | ______________________________________ |
| 5. Major area: | ______________________________________ |
| 6. Related area: | ______________________________________ |
| 7. University: | ______________________________________ |
| 8. College/School: | ______________________________________ |
| 9. Department: | ______________________________________ |
| 10. Academic Record: | ______________________________________ |
College/University
(most recent first) Dates Major Degree GPA
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
11. Name and address of major academic adviser:
12. Progress toward doctoral degree (indicate month and year scheduled for completion):
| Date completed | Date scheduled | |
| Admitted to graduate school | ________________ | ________________ |
| Course work completed | ________________ | ________________ |
| Preliminary exams taken | ________________ | ________________ |
| Research proposal developed | ________________ | ________________ |
| Research proposal approved | ________________ | ________________ |
| Pilot study completed | ________________ | ________________ |
| Admitted to candidacy | ________________ | ________________ |
| Data collected | ________________ | ________________ |
| Data analyzed | ________________ | ________________ |
Respond to items 13-18 on an attachment (not to exceed 2 pages) in numbered sequence. For readability, use type size not less than 11 pt. and single spacing.
13. Kappa Omicron Nu: _________________________________ Chapter,
Year initiated_______
Participation/activities:
14. Professional positions, incl. graduate assistantships (most recent first):
Position Name of
Employer Dates Major
Responsibilities
15. Honors and Awards (names and dates):
16. Professional Activities --membership and participation in professional organizations, including professional involvement in community organizations--give evidence of involvement--offices, committees, etc.:
17. Recent professional development activities:
18. Publications (books, refereed articles, technical publications):
19. Attach a one-page summary of your professional goals and plans.
20. For the developed research problem, attach a one-or two-page summary that includes a)
title, b) objectives, c) significance of study, its contribution to knowledge and application to the field, d) relevance to significant concerns related to home and family, e) description of design and methodology including sample, and f) contribution of study to professional goals.
21. Names of three persons who will submit letters of recommendation:
a. Academic Adviser: ____________________________________
b. ___________________________(role):___________________
c. ___________________________(role):___________________
I do___ do not___ waive the right of access to the recommendations.
___________________________________________________________________
Signature
Social Security Number Date
To Be Completed by the Applicant:
I do___ do not___ waive the right of access to the recommendations.
Signature__________________________________________
RECOMMENDATION FOR KAPPA OMICRON NU DOCTORAL FELLOWSHIP
Return by January 15 to Kappa Omicron Nu, 4990 Northwind Drive, Suite 140, East Lansing, Michigan 48823-5031
________________________________________________________________
Name of Applicant
How long and in what capacity have you known the applicant?
The criteria for this award are active membership in Kappa Omicron Nu, demonstrated ability in graduate study, demonstrated interest and competence in research, and potential for professional leadership in home economics or one of the specializations.
Your letter of recommendation should address the above criteria, with particular emphasis on the nature and significance of the research and assessment of progress toward completion of the degree and dissertation.
In addition to the letter of recommendation, please rate the applicant by checking (X) one term which best describes the candidate with respect to
| Outstanding | Excellent | Good | |
| Academic ability | _____ | _____ | _____ |
| Leadership potential | _____ | _____ | _____ |
| Research ability and progress | _____ | _____ | _____ |
_______________________________________________________________
Signature Title Date
_______________________________________________________________
Institution or Agency