Application for Graduate Student Research Award

2017-18 Application

Please supply all information indicated below. You may submit your answers as a Word document, PDF, or via email to ssmith@labschool.ucla.edu

Name
First Last
School/Department
Year in Graduate School
Degree Objective
Faculty Recommending You
Language(s) in which you are Fluent
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Campus Phone
Home Phone
Email

Additional queries about the CONNECT Research Fellowship and/or the application process should be directed to Sandra Smith, Assistant Director of CONNECT at ssmith@labschool.ucla.edu

Application by email is preferred. Please submit applications to:

Sandra Smith
ssmith@labschool.ucla.edu
CONNECT
UCLA Box 951619
Los Angeles CA 90095-1619