American Mathematical Society
Centennial Fellowship for 2009-2010
Application Form
Applications should be filed no later than December 1, 2008 They should be sent to:
Membership and Programs Department
American Mathematical Society
201 Charles Street
Providence, RI 02904-2294
All of the questions below should be answered completely. The only additional materials which will be accepted are a publication list, a list of positions held, a 3 page research plan, and a cogent plan (one paragraph) detailing how the fellowship will be used. See the directions in this list.
- Date:_________________________________
- Name in Full (First, Middle, Last):____________________________________________________________________________
- Present Address:______________________________________________________________
- Email Address:________________________________________________________________
- Telephone Number:_____________________________________________________________
- Fax Number:__________________________________________________________________
- Present Position:___________________________________________________________
- All Positions and Fellowships since Ph.D.: Attach separate list. (do not attach a vita )
Note: The applicant should list all fellowships and comparable research appointments, such as a term at one of the mathematics research institutes.
- I currently hold a tenured, tenure track, postdoctoral, or comparable position at an institution in North America. Yes _____ No ______ Institution: ___________________________
Note: The applicant must currently hold a tenured, tenure track, postdoctoral, or comparable (at the discretion of the selection committee) position at an institution in North America.
- Graduate Education (Institutions Attended with Dates, Degrees, Date Awarded (mo/day/yr )):
- Doctoral Thesis Advisor:_____________________________________________________
- Title of Thesis:_________________________________________________________
- Honors Received _______________________________________________________
- Publications: Attach separate list. (do not attach a vita )
- References: List three (no more than three will be accepted ).
Note: The applicant's references should send their reference forms to the Membership and Programs Department at the above address to arrive by December 1, 2008. The procedures the selection committee will follow make it essential that these forms arrive on time. Applicants are responsible for seeing that their references respond promptly.
- Name and institution:______________________________________________________
- Name and institution:______________________________________________________
- Name and institution:______________________________________________________
- Research: Please describe the research in your thesis and other work you have done (1 to 3 pages; no more than 3 pages, including bibliographical references, will be accepted) and provide a cogent plan (approximately one paragraph) indicating how the fellowship will be used including travel to at least one other institution.
- Signature of Applicant ______________________________________________________
|
