2023 Garden Club of America Centennial Pollinator Fellowship Application Form

2023 Garden Club of America Centennial Pollinator Fellowship Application Form

Applicant Information
Name*

First Name Last Name
Home Mailing Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number*

Area Code Phone Number
Permanent Email*
example@example.com
Biography: Provide a biography describing your background, current educational pursuits, future plans, and any personal interests or activities.*

0/500
Personal Statement: Provide a personal statement describing your interest in pollinators and how it relates to this fellowship.*

0/150
Photo: Provide a 300 ppi 4x6 inch color .jpg photograph. It should be a head shot with a plain background in which you are looking directly at the camera. GCA and P2 retain the rights to use any photo submitted on our websites and in materials promoting the fellowship.*
Résumé (2 page max) – Upload a PDF of your résumé or curriculum vitae (CV). It should include your education, professional experience, extra-curricular activities, and honors and awards.*

University Information
University Name*
University Mailing Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Faculty Advisor*

First Name Last Name
Faculty Advisor's Email*
example@example.com
Enrollment Date*

MonthDay Year
Date
Anticipated Graduation Date*

MonthDay Year
Date
Overall GPA*
GPA Within Major*

Letters of Recommendation
Please list the following information for each of the three people who will be sending references for you. All applicants are required to have their three references submit the letter of recommendation form by January 15, 2023. Please make sure that one of your references is from your faculty advisor. Please send the following link to each of your references: https://form.jotform.com/222845134732151
Reference 1: Faculty Advisor*

First Name Last Name
Relationship to Applicant*
Phone Number*

Area Code Phone Number
Email*
example@example.com
Reference 2*

First Name Last Name
Relationship to Applicant*
Phone Number*

Area Code Phone Number
Email*
example@example.com
Reference 3*

First Name Last Name
Relationship to Applicant*
Phone Number*

Area Code Phone Number
Email*
example@example.com

Study Objectives
Study Title*
Study Site/Geography*
State/Region
Proposed Timeline for Research Project*
Study Description – Provide a Study ObjectiveSummary.*

0/100
Priority Area – Which priority area(s) will this study address?*

1. Effects of nutrition, genetics, pesticides, pathogens, parasites, and disease on pollinators2. Pollinator habitat development, assessment, or monitoring3. Plant-pollinator interactions and pollination biology4. Research that examines other aspects of pollinator health, including cutting-edge, original concepts
Written Proposal – The proposal must contain a title, priority area focus/foci, an objective, and method. Specify what portion of work has already been completed, if any.*

Browse Files
Upload pdf file. 2,000 word limit. Cancelof
Budget – As non-profit organizations, The Garden Club of America and the Pollinator Partnership do not pay overhead on funded fellowships. Please indicate whether the proposal is under consideration by other funding organizations.*

Browse Files
Upload pdf file. 500 word limit. Cancelof
DECLARATION

I confirm that the information given on this form is, to the best of my knowledge and belief, true and accurate. I understand that if I have given misleading information on this form, this will be sufficient grounds for terminating my application.

I agree that the information provided on this form may be shared with the Garden Club of America and the Pollinator Partnership.
Please call 415.362.1137 or email sc@pollinator.org for any questions.
Agreement*

I have read and agreed to the above declaration.
Should be Empty: