2003 Application Form
Print out the form below, fill in the questions, and send by postal mail to the Women's Division.
Name ___________________________________________________________________________
Address _________________________________________________________________________ _________________________________________________________________________________
Home Phone_____________________ Daytime phone_______________________ Age_______ Name of Church__________________________________________________________________
Briefly describe your educational background, both formal and informal. (Be specific about degrees earned and institutions attended.)
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Describe your work experience (employed and volunteer) __________________________
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Describe the Community Service/Global Citizen Project you wish to undertake:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
What is your understanding of the role, responsibilities, and current interests of the Women’s Division? In what manner does your Project relate to current emphases of the Women's Division?
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In what region or country will your exploration/study be conducted?
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What will be the duration of the Project? __________________________________________
Describe your community service experience: _________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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List three persons who may be contacted as references:
1. _______________________________________________________________________________
Name Title/Relationship
Address Tel./Fax #
2. _______________________________________________________________________________
Name Title/Relationship
Address Tel./Fax #
3. ______________________________________________________________________________
Name Title/Relationship
Address Tel./Fax#
How did you learn of this Award?
_________________________________________________________________________________
Additional information:
Please attach a brief biographical sketch, resume and recent (b/w or color) photo approximately 3x4".
If granted the award, you will be asked to submit a proposed budget for the project.
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Signature
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Date
Submit Completed Application Form
to
Women's Division, General Administration
Hoover Award, Room 1501
475 Riverside Drive
New York NY 10115
Application must be postmarked no later than
AUGUST 1, 2002