The Graduate School of Education and Human Development
The George Washington University
The Holmes Scholars Program
The Holmes Scholars Summer Institute 2006

    APPLICATION FORM

Name: ________________________________________________________________________________________

School Address: ________________________________________________________________________________________________________________________________________________________________________________

Permanent Address: ________________________________________________________________________________________
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School #: _____________________ Home #: ______________________ Cell #: _________________

Email: ________________________________________________________________________________________

Focus of Doctoral Work: ________________________________________________________________________________________________________________________________________________________________________________
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Year in Doctoral Program: ________________________________________________________________________________________

University where doctoral work is taking place (University/Location/Program): ________________________________________________________________________________________
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Faculty Advisor: _______________________ Dissertation Advisor: _________________________

College Dean: ____________________________________________________________________________________

Focus of Related Work Interest for Summer Institute 2006: ________________________________________________________________________________________________________________________________________________________________________________

Related work: ________________________________________________________________________________________
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Opportunities you would like to take part in while in DC: ________________________________________________________________________________________
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