Arnold and Mabel Beckman Foundation

2006 BECKMAN SCHOLARS PROGRAM

Application Cover Page

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Name of Academic Institution:

Name of University/College President/Chancellor:

Address:

City: State: Zip Code:

Phone Number: area code: number:

Institutional Award Category (i.e. Research I, II; Doctoral I, Masters I, Baccalaureate I):

Institutional contact person responsible for application communications:

Name and Title:

Address:

City: State: Zip Code:

E-mail:

Phone: FAX:

Name(s) of participating academic unit(s) included in this application:

2004-2005 representative names of the most significant external funding sources for research activities (including amount) in each of the participating academic unit(s) (government agencies, private foundations, industry): (no more than ten)

Institutional Endorsements:

Chief Institutional Academic Officer:

Name:

Signature:

Title:

Dean of College/School/Division for Participating Academic Unit (1):
Name:

Signature:

Title:

Dean of College/School/Division for Participating Academic Unit (2):
Name:

Signature:

Title:
Dean of College/School/Division for Participating Academic Unit (3):
Name:

Signature:

Title:

Note: This Application Cover Page, accompanying Institutional Data Sheet and Faculty Mentor Summary Data tables must be typed (employing standard fonts no smaller than 12 point) and must accompany an application of up to six pages and one appendix (no double-sided copies). Original and thirteen (13) copies of printed application and accompanying materials (three-hole punched, separated by sheet of colored paper and NO STAPLES OR CLIPS) must be received by Monday, October 3, 2005 at 5:00 p.m., PST. Fax or email submissions are not acceptable.

 

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If you have any problems with this form, please email beckmanscholars@beckman-foundation.com for assistance.

Thank You

[2006 Scholars Program] [Institutional Data Sheet] [Faculty Mentor Summary Data Sheet] [Mentor Data Table]