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UNIVERSITY OF ROCHESTER

Fellowships Office, Dewey 4-209B, 276-5869

FELLOWSHIPS PRELIMINARY QUESTIONNAIRE for AY 2012-13 Competitions

Dear Prospective Fellowship Applicant:

This Fellowships Preliminary Questionnaire (FPQ) is designed to motivate you to get an early start onyour fellowship/scholarship quest; it also serves to help the Director of Fellowships better advise you onappropriate awards to pursue. Moreover, this questionnaire provides information that may help uswrite a more personalized letter of institutional endorsement when this is required, one that trulyreflects your distinguishing characteristics and unique accomplishments. Finally, completing the FPQwill give you a jump-start on your applications for graduate school.

In order to present a competitive application and receive serious consideration for a prestigious nationalmerit-based award (such as Beinecke, Goldwater, Truman, Udall, Carnegie Junior, Churchill, Fulbright,Gates Cambridge, Marshall, NSF, Rhodes, Soros) it is critical that you begin the application process wellin advance of national deadlines. Campus deadlines may commence 2-6 months before national

application deadlines for fellowships that require university nomination or endorsement . It isnecessary that you research carefully the fellowships that interest you, reading all the eligibilityrequirements and selection criteria. You will also need to engage in honest self-reflection on yourgoals, values, academic achievements, and extracurricular record in relation to the award in question and what it seeks to promote . In other words, you have some homework to do before you decidewhether or not to apply for a particular fellowship.

The detailed information you provide in your FPQ is a critical tool in helping us to help you, whether ornot the fellowship requires University nomination or endorsement.

If you wish to apply in AY 2012-13 for an award with a national deadline in the fall , please complete

and return your FPQ to the Fellowships Office via e-mail ([email protected]) by March 3,2012.

If you wish to apply in AY 2012-13 for an award with a national deadline in winter/spring , pleasecomplete and return your FPQ to the Fellowships Office via e-mail ([email protected]) byOctober 2, 2012 .

*** After submitting the FPQ, call the Fellowships Office (276-5869) or stop by Dewey 4-209B to schedule anappointment with the Director of Fellowships ( Belinda Redden) to discuss your potential competitivenessfor the awards that interest you and your application strategy for specific fellowships. Please allow at leastthree business days between the submission of your FPQ and your appointment date so that yourquestionnaire can be reviewed before the meeting.

Submit your FPQ via e-mail to

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UNIVERSITY OF ROCHESTERFellowships Office, Dewey 4-209B, 276-5869

FELLOWSHIPS PRELIMINARY QUESTIONNAIRE AY 2012-13 Competitions

Name Class Year Student ID#

E-mail Local Phone No.

Local Address Rochester, NY Zip

Major(s) Minor(s) Cumulative GPA

Take Five/KEY Program Topic (if applicable) Certificate(s)

Permanent Address Apt/Unit #

City State Zip State of Legal Residency

Permanent Phone Number Country of Citizenship

If you are a permanent resident, are you currently seeking U.S. citizenship? Yes No

If yes, when do you expect to receive your U.S. citizenship?

Indicate four persons whom you would ask to write letters of recommendation in support ofyour fellowship application(s):

1) Full Name Title or Position

Dept./Professional Affiliation

Phone E-mail



Phone E-mail



Phone E-mail



Phone E-mail

Fellowships Preliminary Questionnaire AY 2012-13 2

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Check the box beside the fellowship(s) you wish to apply for during AY 2012-13.For each award of interest, submit a brief statement (100-150 words for each award) indicating in what ways you satisfy the specific selection criteria and goals of the fellowship program(s) .

Carnegie Junior Fellowship (CJF)

Field of interest:

Career goal:

Churchill Scholarship

Preferred Cambridge degree & field of study:

Career goal:

Fulbright Grant (check one: Study/Research English Teaching Assistantship Creative/Performing Arts)

Field: Country: Language:

Career goal:

Gates Cambridge Scholarship

Preferred Cambridge degree & field of study:

Career goal:

Jack Kent Cooke Graduate Arts Award

Intended graduate degree & field of study:

Career goal:

Javits Fellowship


Career goal:

Marshall Scholarship

Preferred UK institution: Degree & Field of study:

2nd-choice UK institution: Degree & Field of study:Career goal:

Mitchell Scholarship

Preferred institution: Degree & Field of study:

Career goal:


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National Science Foundation Graduate Research Fellowship (NSF)


Career goal:

Rhodes Scholarship

Preferred Oxford degree & field of study:

Career goal:

Soros Fellowship for New Americans


Career goal:

Beinecke Scholarship


Career goal:

Goldwater Scholarship

Primary research interest:


Career goal:

Institute for International Public Policy Fellowship (IIPP) Language(s) & Geographic area(s) of interest:


Career goal:

National Institutes of Health Undergraduate Scholarship (NIH)


Career goal:

Truman Scholarship

Primary public-service focus:


Career goal:


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Udall Scholarship

(Please indicate: Environmental Native American/Tribal Policy)


Career goal:

UNCF-Merck Undergraduate Research ScholarshipPrimary research interest:


Career goal:

OTHER AWARDS: indicateaward name, your field of study, intended graduate degree, career goal or professional aspiration .

1. Award:

Field:

Degree: Goal:

2. Award:

Field:

Degree: Goal:

3. Award:

Field:

Degree: Goal:

4. Award:

Field:

Degree: Goal:

5. Award:

Field:

Degree: Goal:


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ACADEMIC INFORMATION

1. Explain your choice of major(s) and minor(s)? Include some discussion of the role ofparticular courses, projects, readings, professors, etc., in your decision to pursue yourchosen field(s) of study.

2. What are your principal academic/creative interests beyond your concentration(s)? In whatway(s) do you pursue these interests?


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3. If relevant, please describe your Take Five or KEY program and why you are pursuing it.

4. What languages other than English do you know? How did you acquire this knowledge andhow do you maintain your proficiency?

5. List merit-based awards, honors, and special recognitions received while in college or for college. Freshmen and sophomores may include most significant high-school honors. Pleasedo not abbreviate award names. Indicate a) award selection criteria or purpose; b) sponsorof award or honor; c) date received and/or duration (e.g., Spring 2009, Fall 2009-Spring2010, 2009-13).

6. Describe any independent study , research , internships , teaching assistantships, workshopleadership , etc., in which you have participated. Indicate a) when and where the activitywas carried out; b) duration of your participation; c) basis of selection/how you obtainedthe position; d) who supervised you; e) your role or duties; f) significance of experience inyour academic and personal development/what you gained; g) presentation or publicationof work.


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7. What has been your most meaningful intellectual/creative accomplishment in college thusfar and why? If you have not yet had such an experience, what do you hope to accomplishin your studies beyond excellent grades in coursework?

8. If you have studied or traveled abroad (including family trips), when and where did you goand why did you choose that destination? How long were you abroad? Discuss the impactof the international experience on your studies, personal growth, world outlook, post-graduate plans, and career goals. If you will study abroad in the future, indicate when,where, and why.

9. Please explain the circumstances of any semester in which your academic performance didnot reflect your ability.


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10. Please explain if there has been any interruption in your education. When and how longwere you away from schooling; what did you do during this time?

11. What are your post-baccalaureate plans? For example, if you plan to go to graduate school,indicate what you plan to study and what degree you will seek; also indicate where youdmost like to study, if you know this now. What profession/career do you aspire to and whatdo you wish to accomplish in this realm? If you plan to seek employment rather thanpursue graduate education, what kind of work do you hope to do and why is this importantto you?

EXTRA-CURRICULAR & SERVICE ACTIVITIESFor all activities below, list in reverse chronological order with period and frequency of participation .Also indicate a) any leadership roles; b) the importance of each activity to your personal and intellectualdevelopment; c) your most significant accomplishment(s) or contribution(s) for each endeavor; includehow you demonstrated initiative or creativity.

1. Campus activitiese.g., student government, residential life, social/cultural clubs andassociations, committees, political and advocacy organizations, undergraduate councils,athletics, creative/performing arts.


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2. Off-campus activitiese.g., community/volunteer work (specify whether or not workassociated with a University group or office), leadership training, civic engagement, etc. Inaddition to the information requested above, indicate the full name and nature of the groupor activity, how you became involved, and your supervisor.

3. Reflect on one recent particularly satisfying public service or volunteer activity in which youparticipated. Why was this endeavor important to you, and how did you make a difference?

4. Reflect on one recent specific experience or activity in which you demonstrated yourleadership capacity and made a positive difference on campus or in the wider community.


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5. Describe any special talents you have that are not mentioned elsewhere.

6. What are your hobbies or special interests? How long have you been engaged in thesepursuits and how often do you engage in them now?

SUMMER PLANS:If not indicated elsewhere, please describe your plans for the upcoming summer.

EDUCATIONAL EXPENSESSome fellowships take financial need into consideration; therefore, please indicate how your educationis being financed. Indicate merit awards as well as need-based financial aid; specify source (e.g., URgrant, federal loan, etc.) and duration of funding (e.g., one year, one-time, four-year award, etc.). It isnot necessary to provide dollar amounts. Please also note if the necessity of working to help pay youreducational expenses has influenced your choice of jobs and/or your level of participation in otheractivities.


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FAMILYBriefly tell us about your family background. Where did you grow up? Is there an unusual familycircumstance that you would like to mention? What is the educational level of your parents and what

are their occupations or professions? Are you a first-generation American or first-generation collegestudent? Did your parents immigrate to the U.S.? If so, when and from what country(ies) did they cometo the U.S.? How do you maintain a relationship with your/your parents country of origin?

RSUMPlease attach an up-to-date rsum. Be sure to include dates, as well as locations when appropriate.

PERSONAL ESSAY: TO BE COMPLETED ON A SEPARATE SHEET & ATTACHEDIn two single-spaced pages or less, please reflect on each of the following topics:

a) how you define your most notable character traits; what has influenced them, e.g., ideas, beliefs,experiencesb) how you believe others define your personality and characterc) an experience of failure or great disappointment and how you handled it/what you learned from itd) an experience that has taken you outside of your comfort zone and how that experience has affectedyour worldview and self-perceptione) the motivation and purpose behind your post-baccalaureate educational plans and career and/or

professional aspirationswhat compels you to pursue these goals and what problems/issues/needs doyou wish to make a difference in through your chosen pathf) an individual or experience that has been especially inspirational to you in the development of youracademic and/or career goalsg) your alternative plans if you are not able to pursue your first-choice path


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