Graduate Scholar In Residence application

Personal Information

First Name *

Last Name *

Home Address *

City *

State *

Zip Code *

Cell Phone Number *

Primary Email Address *

Alternate Email Address

Academic Affiliation

University *

Academic Department/Program of Study *

Title of Dissertation *

Dissertation Advisor *

Dissertation Advisor's Email Address *

This information is for record-keeping purposes only. The Newberry will not contact your advisor to request letters of recommendation.

Letters of Reference

Reference #1

First Name *

Last Name *

Academic Affiliation *

Email Address *

This information is for record-keeping purposes only. The Newberry will not contact your recommender to request letters of recommendation.

Reference #2

First Name *

Last Name *

Academic Affiliation *

Email Address *

This information is for record-keeping purposes only. The Newberry will not contact your recommender to request letters of recommendation.

Additional Information

How many hours per week do you anticipate using the collections? *

Please list your anticipated teaching obligations for the 2015-2016 academic year. *

Uploads

Uploads support .doc, .docx, and .pdf files with a maximum of 2MB per file. Please adhere to the word and page limits below. In order to upload your materials, click on the "Browse" button; a window will open up that will allow you to access your hard drive. Find the appropriate document on your hard drive; highlight it and click "Open." If the text next to the "Browse" button no longer reads "No file selected," click "Upload." When the title of your document has a "Remove" button next to it, you will know that you have uploaded your document successfully.

Project Description *

No more than 1,000 words
Files must be less than 2 MB.
Allowed file types: pdf doc docx.

Curriculum Vitae/Resume *

No longer than 5 pages
Files must be less than 2 MB.
Allowed file types: pdf doc docx.

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