Applicant Name: ______________________
2016-2017
INTERSCHOOL FELLOWSHIP APPLICATION
Personal & School Information
Name of Applicant: ______________________________________________________
US Citizen:
Yes
No
UNI: __________________________________________
E-mail Address: ______________________________________________________________________________________
Name of School Attending: _____________________________________________________________________
Degree being sought: ________________
Major Field of Study: ________________________________
Month/Year Expected to Complete Studies: ____________________________
Have you applied for the any Interschool Fellowship(s) in the past?
Yes
No If yes, in what year: _________________
What is the name of the fellowship you’re applying for: _______________________________
Educational History
1.
Name of Institution: ________________________________________________________________________________
Degree: ____________________________________
Major Field of Study: _________________________________
Completion Date: __________________________________________________________________________________
Financial Information
Tuition Amount you expect to pay next year: ___________________________________________________
Will this tuition amount vary significantly in future years?
Yes
No
If yes, please explain: ____________________________________________________________________
Current Liabilities
1.
Name of Lender: __________________________________ Type of Loan: ___________________________
Date Incurred: ____________________________________ Balance Due: ___________________________
Due date for full payment: __________________________ Monthly Payment Amount: _________________
Currently in Deferred status:
2.
Yes
No
Name of Lender: __________________________________ Type of Loan: ___________________________
Date Incurred: ____________________________________ Balance Due: ___________________________
Due date for full payment: __________________________ Monthly Payment Amount: _________________
Currently in Deferred status:
Page 1 of 4 – Interschool Fellowship Application for 2016-2017
Yes
No
Applicant Name: ______________________
3.
Name of Lender: __________________________________ Type of Loan: ___________________________
Date Incurred: ____________________________________ Balance Due: ___________________________
Due date for full payment: __________________________ Monthly Payment Amount: _________________
Currently in Deferred status:
Yes
No
Application Process
For more information on the application process, please contact your school’s Financial Aid office.
___________________________________________________
Signature of Applicant
/
/
Date
For Use by the Submitting School Fellowship Coordinator Only
Submitted to CU Employee by:
____________________________________________
Signature of the Submitting School Official
_______________________________________
Name of the Submitting School Official
____________________________________________
Office Telephone Number
_______________________________________
Title of the Submitting School Official
_______________________________________
E-mail Address
Page 2 of 4 – Interschool Fellowship Application for 2016-2017
Applicant Name: ______________________
INTERSCHOOL FELLOWSHIPS
Information about the Fellowships, including eligibility requirements, is provided below.
Westmoreland Davis Memorial Foundation Fellowship
The Westmoreland Davis Fellowship is available to undergraduate or graduate students from
Virginia.
Required documentation:
To verify that the student meets this criterion, please submit a tax return or driver’s license.
Clifford and Siegfried Upton Scholarship
This scholarship is intended to benefit the children, adopted children, and step-children of the
employees of Boston-based Houghton-Mifflin Company, its subsidiaries, or successor companies.
The minimum amount of a scholarship is $1,000 for a school year, and increased according to the
needs of the candidate.
This fellowship is available to graduate or undergraduate students.
Required documentation: Letter from employer verifying eligibility.
Leta Stetter Hollingworth Fellowship
This fellowship is available to graduate students at Columbia, to a woman graduating from or
graduated from the University of Nebraska.
Required documentation:

A copy of the student’s transcript from the University of Nebraska

A letter of reference from a faculty of the University of Nebraska.
Paul Nichoplas Scholarship Fund
This scholarship is to benefit a male or female student in any area of the University who has attended
college or university in Greece.
It is available to graduate or undergraduate students for two years.
Required Documentation:

A copy of the student’s Birth Certificate,

An affidavit or transcript.
Page 3 of 4 – Interschool Fellowship Application for 2016-2017
Applicant Name: ______________________
Vladimir and Olga Poder Fund
This fellowship is to benefit an Estonian-speaking students attending Columbia. The fellowship
cannot be greater than $2,000 annually.
It is available to graduate or undergraduate students.
Required documentation:
To verify that the student speaks Estonian, please submit a letter from the NY Estonian House
located at 243 East 34th Street, New York NY 10016.
George W. Ellis Fellowship
The George W. Ellis Fellowship is available to graduate students who are residents of Vermont or
who have graduated from an accredited Vermont college or University.
Required documentation:

Residents of Vermont should provide a copy of taxes, driver’s license

Voter registration.

Graduates from a Vermont College, should provide a copy of transcript.
Page 4 of 4 – Interschool Fellowship Application for 2016-2017