Segf Graduate Student Fellowship Application Form Page 2
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2SEGF Graduate Student Fellowship pplication, Page 2
pplicant Name ___________________________________
Describe briefly any undergraduate and/or graduate research projects that you have completed and/or have in progress. In-
clude the project title if you have/had one.
If you have not yet undertaken any research projects, do you have any research topics in mind? If so, describe briefly and in-
clude your intended field of study (e.g., epithermal gold deposits):
What are your career goals?
List any geology work experience (part time or other) that you have had.
Provide the name(s) of the university(ies) or institution(s) to which you have applied for graduate school admission and the
status of your application(s). If you are currently enrolled at a university and pursuing graduate studies, provide the name of
that university and the status of your graduate studies.
List any support, direct and indirect, you are receiving or will receive during your enrollment as a graduate student, including
but not limited to, scholarships, fellowships, sponsorships, grants-in-aid, living allowances, as well as any university tuition
and/or fee waivers.
Please provide a brief biographical sketch, including educational and work history.
Name of Reference 1:
Name of Reference 2:
Signature of Applicant_________________________________________________ Date _____________________________
The completed application form, together with required documentation and references must be submitted to
Chair, SEGF GS Fellowship Program at: and received at SEGF by February 1, 2016.
9 2016
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