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1. NAME ___________________________________________________________________
2. PRESENT ADDRESS ________________________________________________________
3. PHONE NUMBER ___________________________________________________________
4. PERMANENT ADDRESS ______________________________________________________
5. PHONE NUMBER ___________________________________________________________
6. SOCIAL SECURITY NUMBER _________________________________________________
7. COLLEGE/UNIVERSITY _____________________________________________________
8. DES CHAPTER ___________________
9. CHAPTER ADVISOR ____________________
10. GRADUATION DATE _______________
11. CURRENT CUMULATIVE GPA _____________
12. MAJOR _________________________
13. DEGREE SOUGHT ______________________
14. List GRE, GMAT, MCAT, LSAT, DAT, Miller Analogies or other appropriate
test scores and
attach a copy of the test score report.
Exceptions to
this requirement must be explained by the advisor.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
15. HONORS AND AWARDS _______________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
16. LEADERSHIP AND SERVICE ACTIVITIES _________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
17. Intended area of graduate/professional study ___________________________________
________________________________________________________________________
18. Intended graduate/professional degree ________________________________________
________________________________________________________________________
19. Name of graduate/professional school ________________________________________
________________________________________________________________________
20. Admission to graduate/professional school completed: Yes _____ No ______
21. In a one-two page essay describe your purpose in pursuing graduate
study and its relation to
your career objectives.
Explain what
particularly qualifies you for a DES Fellowship. Describe
any
circumstances that may be helpful in assessing your need for financial
assistance.
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