GOTTLIEB FELLOWSHIP APPLICATION — Center for Character & Citizenship

DAVID GOTTLIEB CITIZENSHIP EDUCATION FELLOWSHIP

NOMINATION FORM | DEADLINE MAY 31ST ANNUALLY | $1500

In order to be considered for this award, please complete the application for below. When describing the reason that the Center for Character and Citizenship (CCC) should consider this applicant, please outline their relevant work and/or focus of study; how they fit with the CCC mission and, most important, the fit with the fellowship’s focus on citizenship education. Contact us for more information at ccc@umsl.edu.

I am applying for

Myself

Nomination for someone else

The nominee is a current Graduate Student at UMSL

Only current UMSL graduate students are eligible.

Yes

No

About the Applicant / Nominee

Nominee's Name

First Name

Last Name

Email

Address

City

Zip Code

Country

Phone Number

(###)

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Why should you (or this person) be considered for the Gottlieb award?

Be specific. Describe relevant work and/or focus of study; fit with the CCC mission; fit with the fellowship’s focus on citizenship education. What is unique about this student?

Is there anything else you would like to add?

About the Nominator (if nominating someone else)

If you are nominating someone else, what is your relationship to the Applicant?

Nominator's Name

First Name

Last Name

Nominator's Email

Nominator's Phone Number

(###)

###

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A CCC staff member will be in touch with you after you submit the application. Please e-mail us at ccc@umsl.edu if you have any questions.

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