APPLICATION FOR KAPPA OMICRON NU MASTER'S FELLOWSHIPS Five (5) copies of this application form, typed or printed, and all supporting documents should be postmarked on or before April 1 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) 3. ____________________________________________( )___________ (City, State, ZIP Code) Telephone 4. _____________________________________________________________ Home Address (Street) 5. ____________________________________________( )___________ (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: Respond to items 12-17 on an attachment (not to exceed 2 pages) in numbered sequence. For readability, use type size not less than 11 pt. and normal spacing. 12. Kappa Omicron Nu:____________________________________Chapter, Year initiated_______ Participation/activities: 13. Professional positions, including graduate assistantships (most recent first): POSITION NAME OF EMPLOYER DATES MAJOR RESPONSI- BILITIES 14. Honors and Awards (names and dates): 15. Professional Activities--membership and participation in professional organizations, including professional involvement in community organizations--give evidence of involvement-- offices, committees, etc.: 16. Recent professional development activities: 17. Publications(books, refereed articles, technical publications): 18. Attach a one-page summary of your professional goals and plans. 19. For the developed thesis topic, 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. If the thesis or study has not been developed, provide as much detail as possible about your research interests. 20. 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 MASTER'S FELLOWSHIP Return by April 1 to Kappa Omicron Nu, 4990 Northwind Drive, Suite 140, East Lansing, MI 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 scholarship, demonstrated interest in research, and potential for professional leadership in home economics or one of the specializations. Your letter of recommendation should address the above criteria. 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 END OF DOCUMENT