ALICE HAMILTON SCHOLARSHIP FUND

Application Submission Cover Sheet

(to be completed by Applicant)

 

Full Name:

 

Mailing Address:

 

Phone (Day):

 

Phone (Evening):

E-mail:

 

College/University:

Department:

 

 

Letters of Reference:     1.________________________________________________________(name)

                                    2.________________________________________________________(name)

 

Education Level:           Undergrad  Masters Candidate  PhD Candidate

Scholarship Use:           Field School  Thesis Fieldwork  Lab Analysis/Tests  Other

 

I AM  I AM NOT -- willing to share my experiences and/or project results with a local CAS chapter (typically a short newsletter article, poster or presentation)