Form GSDF, Graduate Diversity Doctoral Fellowship Award nomination form Rev 07/2020. Page 1 of 2
CLEMSON UNIVERSITY GRADUATE SCHOOL E-106 Martin Hall Clemson, SC 29634-5713 864.656.5202
GSDF Graduate Diversity Doctoral Fellowship Award
Application for Doctoral Students
Clemson University provides limited funding to support the institutional goal to increase the enrollment and retention of domestic
doctoral students of color who are pursuing the professoriate. The Diversity Fellowship Program considers requests received directly
from students or programs for financial support depending on need and/or merit ,under the following conditions,: Students can
apply for up to $5,000 per year for no more than four years and a one-time supplement of $2,000 for scholarly and professional
development support. The Graduate School Diversity Fellowship Committee meets several times throughout the year to make
awards to incoming students. Continuing fellowship support is determined following a review of academic progress at the end of
each semester. Students must demonstrate full-time enrollment and satisfactory progress for continuation funds to be awarded.
If completing form by hand, please PRINT or TYPE
Name XID# (CUID)
Citizenship Number of dependents
Department to which you are applying
Graduate degree program
Residency: Beginning semester for which assistance is desired:
£
In-state resident
£
Fall: August 20 ______ (year)
£
Out-of-state resident
£
Spring: January 20 ______ (year)
Anticipated date of graduation
Mailing address
Apartment number and street, P.O. box, etc.
City State Zip Country (if not U.S.)
Email address Telephone (day) Telephone (evening)
Education
Undergraduate degree and major Date of degree Institution
Master's major (if applicable) Date of degree Institution
What are your career objectives?
Teaching or research experience (include as a graduate assistant):
Employment experience in related fields:
Form GSDF, Graduate Diversity Doctoral Fellowship Award nomination form Rev 07/2020. Page 2 of 2
CLEMSON UNIVERSITY GRADUATE SCHOOL E-106 Martin Hall Clemson, SC 29634-5713 864.656.5202
GSDF Graduate Diversity Doctoral Fellowship Award Application for Doctoral Students (continued)
Academic honors you have received:
Scientific, scholastic, and honorary organizations to which you belong:
Current employment (outside of Clemson University):
Further comments or additional information that may be helpful in evaluating your application:
The Graduate School Diversity Fellowship Committee composed of one or more Graduate School deans and an administrator from
the Office of Access and Equity determines awards based on need as well as merit. Need is determined by documentation provided
by the student (preliminary FAF and/or income tax documentation from the previous year). Merit is determined by a review of courses,
grades earned, and/or standardized test scores. Please provide the appropriate financial documentation with this form.
Signature of applicant Date
Return completed form with financial documentation to:
The Graduate School
E-106 Martin Hall
Clemson, SC 29634-5713
Or click this link to submit via email
(Don’t forget to attach financial documents)
GS_FORM_TEMP_PROCESS@LISTS.CLEMSON.EDU
GRADUATE SCHOOL USE ONLY BELOW THIS LINE
Institutional Action
£
Student notified of support Amount: $
£
Student notified of non-support Reason:
Staff member name (print) Date
Staff member signature
click to sign
signature
click to edit
click to sign
signature
click to edit