Name:___________________________________________	Bates ID:____________________________
Bates P.O. Box:____________________________________________	Class Year at Bates:_________________
Bates Email:____________________________________	Abroad Email (if different):__________________________
Home Address:________________________________________	Home Phone:__________________________
Study Abroad Program/University:_____________________________	Period of Study Abroad:______________________________
Major:__________________________________________	Faculty Advisor:_____________________________

Application for (circle one):

Barlow Fellowship

Enrichment

Thesis research

Campus/Comm. Activity

For Barlow Fellowship applications: Describe your overall plan of study, including (to the degree possible) the related courses at Bates, personal and academic goals for study abroad, planned courses abroad, anticipated additional activities, and thesis topic/senior year activity. Use the reverse side and, if necessary, an additional page (maximum two pages). If appropriate, please be sure to discuss how a Barlow Fellowship Grant will enhance your study abroad experience. In addition, please provide a letter of support from your faculty advisor. Students do not need to itemize anticipated expenditures.

For Enrichment Grants: Describe the activity, time period, location, and how it will enrich your study abroad experience. Itemize the individual and total dollar amounts requested, using the categories listed below.

For Thesis Research Grants: Describe the use of the funds, including the time of their use and contribution to your thesis. Below, itemize the individual and total dollar amount requested. In addition, provide evidence of consultation and support (a letter or email) from your faculty advisor.

For Community/Campus Acticity Grants: Describe the activity, with particular reference as to its relationship to the campus and/or greater Lewiston-Auburn community. Itemize the individual and total dollar amounts requested, using the categories listed below.

Applications may be submitted using this form, by mail or fax, or by email with the same information. (Fax: 207-753-6971. Email: jya@bates.edu)
 

Total Request	_________			Explanations
Food	_________
Lodging	_________
Travel	_________
Entry Fees	_________
Supplies	_________
Equipment	_________
Other	_________

Signature

___________________________

Date

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