RACIAL/ETHNIC MINORITY GRADUATE SCHOLARSHIP APPLICATION
Applications are due by and must be received no later than February 3, 2012.
All applicants must be current SSSP members when applying.  (Masters level students are not eligible.)

Name:		_______________________________________________________________________________________
		(Last)					(First)				(Middle)

Current Mailing
Address:	_______________________________________________________________________________________
		(Street)					(City)				(State & Zip Code)

Phone:		_______________________________________________________________________________________
(Home)					(Work)

Social Security #:_______________________________	E-mail Address:_________________________________________

Address where you can be reached after the announcement date:
															
____________________________________________________________________________________________________
		(Street)					(City)				(State & Zip Code)

Sex (Circle One):	Male		Female		Date of Birth:___________________________________________

Racial/Ethnic Identification as used in the U.S. Census (check all that are relevant): 

Black or African American	______________	Native Hawaiian or Other Pacific Islander	______________
Hispanic or Latino		______________	American Indian or Alaska Native		______________
Asian or Asian American	______________

Applicant must be a citizen or permanent resident of the United States.

Marital Status (Circle One):	Single		Married		Divorced	Widowed	Separated

Number & Age of 
Dependent Children:	________________________________________________________________________________

____________________________________________________________________________________________________

Your Current Educational Status:
Degree Program:                                                                               	Year in Degree Program: ____________________

Your Education Background:
Institution			Location			Dates Attended			Degree

                                                                                                                                                                                                         	

Have you completed the major requirements for the Ph.D. (i.e., course work, examinations, and submission of a dissertation 
prospectus?)  (Circle One)	Yes		No

Please submit a copy of your dissertation prospectus.

How are you financing your graduate education?  (Please list all sources of support including current scholarships, fellowships, assistantships, loans, and outside jobs.)  Have you received/can you receive financial support from family members?

                                                                                                                                                                                                         	

Please explain how receiving this scholarship would assist you in completing your program.  (A very detailed budget would assist the committee in its deliberation; it is appropriate for the award to be used to support dissertation writing.)

                                                                                                                                                                                                         	

What is your parents’ highest educational level? _____________________________________________________________

STUDENT APPLICATION PROCESS

Complete application packets should be sent to the SSSP Administrative Office. Copies of each application will be made for the committee to consider; please therefore print single-sided and use paperclips instead of staples.  Make sure your application is complete before mailing, as incomplete packets will not be reviewed.  The following checklist is provided for your convenience.  Each packet must include each of the following:

___	Racial/Ethnic Minority Graduate Scholarship Application (complete and print this application and send it in with the rest of your application);
___	An Official Transcript with seal from the student’s Graduate Program Registrar;
___	Resume or Curriculum Vitae;
___	Three letters of recommendation addressing the student’s work and progress in program, including one from the student’s dissertation Advisor.  The letter from the Advisor should address the financial need of the applicant, and should also note that the student will have defended the dissertation proposal and have achieved advanced status in the doctoral program (completed course work, examinations, and approval of their dissertation prospectus) by the end of the Spring 2012 academic year.  
___ 	Each letter should be placed in a sealed envelope with author’s signature over the seal. Letters not included in the packet will not be accepted.  
___	Personal statement of commitment to a career of scholar activism;
___	Fifteen or more double spaced pages of your dissertation proposal

Contact Tyrone A. Forman, Chair, Racial/Ethnic Minority Graduate Scholarship Committee with all questions (W: 404-727-7524 or e-mail tyforman@stanford.edu).

Visit www.sssp1.org to download an application.  Complete application packets should be sent to:

The Society for the Study of Social Problems
University of Tennessee, 901 McClung Tower
Knoxville, TN 37996-0490
W: 865-689-1531; F: 865-689-1534; sssp@utk.edu