Center for the Study of Women and Society

           The Graduate School and University Center, The City University of New York

 

                             Application for the Nina Fortin Memorial Dissertation Award

 

Name                                                                                           Telephone/Fax #                                                                            (Please Print)       
                                   
     
Email ___________________________ 

 

Address                                                                                                                                            
                                             
(Street)                                                             (Apt. #)

 

                                                                                                                                                                    
                       
(City)                                                          (State)                     (Zip Code)

 
 

Doctoral Program                                                                                                                                                   

 

Date of completion of required course work                                                                                                        

 

Date of Advancement to candidacy                                                                                                                        


Research Area                                                                                                                                                         

 

Title of Proposal                                                                                                                                                     

                                                                                                                                                                                                                                 

The following are to be provided:

 

1.         A typed abstract of the dissertation proposal.  A maximum of five pages is recommended.

 

2.         A typed statement on the progress of your dissertation research to date.  A maximum of two pages is allowed.  Be specific.

 

3.         Two written references:  one from your dissertation advisor and one from another professor in your discipline.

 

Names of References:

 

1.                                                                        

2.                                                                          

 

All materials must be submitted by May 26, 2007 to:

 

Elizabeth Small, Assistant Program Officer

Women's Studies Certificate Program, Room 5116

CUNY Graduate School and University Center

365 Fifth Avenue

New York, NY 10016


 

__________________________________________________      

Signature of Applicant/Date                                            
_____________________________________
Signature of Executive Officer/Date