UNIVERSITY OF CALIFORNIA, SANTA BARBARA
Application to UCSB Department of Black Studies Dissertation Fellowship 2019-20
PERSONAL INFORMATION
Name:____________________________________________________________________________________
Last First Middle
Current Address:____________________________________________________________________________
Street
__________________________________________________________________________________________
City State Zip Code
Email:______________________________________ Phone:______________________________
ACADEMIC INFORMATION
Current Institution of Study:___________________________________________________________________
Department/Program:________________________________________________________________________
Dissertation Title and/or Topic:_________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
REFERENCE INFORMATION
1.________________________________________________________________________________________
Name Title/Department Institution
2.________________________________________________________________________________________
Name Title/Department Institution
3.________________________________________________________________________________________
Name Title/Department Institution
Application Checklist
□ Application
□ Cover letter
□ Curriculum Vitae
□ Detailed description of dissertation project
□ Writing Sample
□ Three letters of reference
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Questions may be directed to the Department of Black Studies
Chair, Vilna Bashi Treitler, at VBashiTreitler@blackstudies.ucsb.edu
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