Page 60 - 1926 February - To Dragma

TO DRAGMA OF ALPHA OMICRON PI 223

ALPHA OMICRON PI F E L L O W S H I P F O R
GRADUATE WORK

APPLICATION BLANK
Instructions:

This application will not be complete unless it is accompanied by a
transcript, officially signed by the college Registrar, giving the applicant's
complete scholastic record. Statements from the major professors and
others best qualified to furnish information in regard to the candidate's
scholastic and personal fitness for achievement in graduate research and
leadership should also be submitted with the application. It must reach
the Chairman of the Alpha Omicron Pi Fellowship Committee, Elizabeth
Hevwood Wyman, 456 Broad Street, Bloomfield, N . J., before midnight
of March 15th. A kodak picture or small photograph of the candidate
may be submitted at her option with application. Announcement of award
will be mailed to all applicants not later than May 1st.

Full Name

Date of Birth Place of Birth

Race Nationality

Religion Church affiliation

Graduate of what institutions (state degrees and date of granting)

Major subject or subjects

Other special scholastic training

General physical condition

Are you entirely self-supporting? Partially self-supporting?

I f so, by what kind of work have you supported yourself?

At what college or university do you wish to do graduate work?

What is the specific nature of the course you wish to pursue?

What use do you expect to make of this advanced training? (state your
plans fully)

What organizations or honor societies do you belong to? (include those
outside of college)

In what activities (other than scholastic) have you participated in col-
lege?

What is the line of your greatest interests?

I f you are awarded the fellowship, do you intend to devote your time
solely to a full college schedule?

What do you consider your personal qualifications for success in the work
you wish to follow? (state fully on the other side of this sheet)

Signed

Date