Boston University Office of the Provost
Associate Provost for Graduate Affairs
1 Silber Way, 8th Floor
Boston, Massachusetts 02215
BOSTON UNIVERSITY
WHITNEY M. YOUNG, JR., FELLOWSHIP 2021-2022
(Deadline: February 15, 2022)
NAME_______________________________________________________________________________
Address______________________________________________________________________________
Phone Number &
e-mail
address_________________________________________________________________________
Graduate or Professional School _________________________________________________________
Present Status (entering,
second year, etc.) ______________________________________________________________________
Degree Program_____________________________ Area of
Specialization______________________
Anticipated Date of
Graduation__________________________________________________________
EDUCATIONAL INFORMATION
Colleges and Universities Attended
Dates
Major Minor
Degree
(List most recent first)
From/To Awarded
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
If appropriate, provide titles:
Undergraduate thesis___________________________________________________________________
Master's thesis_________________________________________________________________________
Proposed Doctoral Dissertation__________________________________________________________
Academic honors,
publications, etc._______________________________________________________________________
What sch
olarships or fellowships do you hold or have you held in the past?
______________________________________________________________________________________
______________________________________________________________________________________
Professional societies or student organizations in which you have been active or in which you
have held office:
Volunteer or community activities:
Internships, teaching assistantships, and principal positions held, most recent first:
Name of Institution Title or Position Dates
or Organization
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
PERSONAL STATEMENT
On a separate sheet indicate in 500 words or less your academic interests, professional or career
aspirations, and how these relate to the life and work of Whitney M. Young, Jr.
____________________________________________ ____________________________
Signature Date