Application for Support of Graduate Study

Student Information
Name*
First Middle Last
PeopleSoft Number*
Current Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
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Advisor's Name*
Student Aid
What are you applying for?*
- Fellowship
- Graduate Assistantship
- Summer Fellowship
Academic References*
Faculty 1 Faculty 2 Faculty 3

Please list faculty members who best know your work.
Financial Information*
List all financial awards you received at the University, including starting and ending dates.
Course Enrollment*
List courses you are currently enrolled in, including the course name, number, and instructor.
Supporting Documents
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Department of Political Science

Faculty 1	Faculty 2	Faculty 3

Phone:	(860) 486-2440
E-mail:	pols@uconn.edu
Address:	365 Fairfield Way, Unit 1024 Storrs, CT 06269-1024 Susan V. Herbst Hall, Room 409