FACULTY SCHOLAR AWARD
Cover Sheet

STUDENT INFORMATION

Name:________________________________________________________________________

First Major:_______________________________ Second Major (if any)__________________

Email Address:____________________________________

Campus address:___________________________________

Phone: ____________________

Independent scholarship topic(s): ________________________________________________

GPA: ________ Rank in class: ________ SAT (Critical Reading:  ________ Mathematics: ________ and Writing: _________)

CHECK LIST

Please attach documents to this sheet in the order shown below:

_______Transcript (one certified by Registrar with the other five as copies)

_______Two letters of support from faculty (list name /dept. below)

1._______________________________________________________________

2._______________________________________________________________

________    Student Essay (single spaced — maximum of three pages)

APPLICATION SUBMITTED BY

Name:   _______________________________________________________

Phone number:  ____________________

Chair of Department: __________________________________

DUS: ______________________________________

Department:____________________________________________________________________

Please submit six complete copies on each candidate with this cover sheet on top:

By 3:00 p.m., Thursday, February 14, 2013:

To:   The Faculty Scholars Committee
c/o Academic Council Office (684-6447)
304 West Union Building (West Campus)
Box 90928
Duke University