applicationgaeltachtsummerawards

IRISH LANGUAGE SUMMER GAELTACHT AWARD
APPLICATION
(This form is intended for Lehman College students only. All other students should visit www.fulbright.ie for
the correct form. Lehman students should scan and submit this form to )

COVER PAGE
APPLICANT DETAILS:
APPLICANT NAME
PERMANENT ADDRESS
EMAIL ADDRESS
CONTACT NUMBER

APPLICATION CHECKLIST:
COMPLETED APPLICATION FORM
ACADEMIC TRANSCRIPT
REFERENCE
NAME OF REFEREE
EMAIL ADDRESS
STATEMENT OF PROPOSED ACTIVITY

TO ASSIST THE COMMISSION WITH FUTURE PUBLICITY PLEASE INDICATE
HOW YOU HEARD ABOUT THIS AWARD:
CURRENT LANGUAGE INSTRUCTOR
INTERNET (PLEASE SPECIFY
SOURCE)
Google
www.fulbright.ie
Other
EMAIL ALERT
NEWSPAPER
RADIO

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IRISH LANGUAGE SUMMER GAELTACHT AWARD
APPLICATION

PERSONAL HISTORY
NAME
PERMANENT
MAILING ADDRESS
CONTACT
TELEPHONE
NUMBER
EMAIL ADDRESS
DATE OF BIRTH
MARITAL STATUS
COUNTRY(IES) OF
CITIZENSHIP
HAVE YOU STUDIED
IN IRELAND
BEFORE?
IF YES PLEASE
SPECIFY WHEN,
WHERE, DURATION
AND COURSE OF
STUDE
OCCUPATION
IF STUDENT, PLEASE
SPECIFY YEAR IN

UNDER-GRADUATE
OR POST-GRADUATE
STUDY
CURRENT
EMPLOYER /
ACADEMIC
AFFILIATION

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IRISH LANGUAGE SUMMER GAELTACHT AWARD
APPLICATION

ACADEMIC QUALIFICATIONS/EXPERIENCE
COLLEGES, UNIVERSITIES, PROFESSIONAL SCHOOLS ATTENDED, MOST
RECENT FIRST
Institution

Degree (Discipline)

Grade Awarded

Year
awarded/expected*

Please attach / submit YOUR MOST RECENT ACADEMIC TRANSCRIPT

NAMES AND DATES OF ACADEMIC / PROFESSIONAL HONOURS, AWARDS,
FELLOWSHIPS ETC, MOST RECENT FIRST

Date

Title/Name of award and awarding body

PAPERS PUBLISHED/ACCEPTED FOR PUBLICATION/PRESENTED AT
CONFERENCE MOST RECENT FIRST
Date

Title of Article / Presentation & Publication / Conference

ACADEMIC OR PROFESSIONAL POSITIONS IF ANY, MOST RECENT FIRST
Dates

Institution / Employer

Position

EXTRACURRICULAR ACTIVITIES
Dates

Organisation / Activity

Role / Association

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IRISH LANGUAGE SUMMER GAELTACHT AWARD
APPLICATION

PROJECT PROPOSAL
Details
NAME / LOCATION OF
COURSE THAT YOU WISH
TO ATTEND
DATES / DURATION
PROPOSED COSTS
Tuition
Travel
Accommodation
Meals /Subsistence
Other (please specify)
TOTAL
HAVE YOU APPLIED FOR
THE COURSE OR MADE
CONTACT WITH THE
OFFERING INSTITUTION?
IF SO, WHAT IS THE
STATUS OF YOUR
APPLICATION /
COMUNICATION?
LIST ANY OTHER
SCHOLARSHIPS / AWARDS
THAT YOU HAVE RECEIVED
OR FOR WHICH YOU ARE
APPLYING
SPECIFY THE FUNDS
AVAILABLE TO YOU FROM
OTHER SOURCES FOR
YOUR SUMMER VISIT TO

IRELAND.
REFERENCE
NAME
TITLE
ORGANISATION
EMAIL ADDRESS

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IRISH LANGUAGE SUMMER GAELTACHT AWARD
APPLICATION

PROJECT PROPOSAL
Statement / Rationale
Please outline in NO MORE THAN 2 PAGES
• your motivation and preparation for studying the Irish language and this particular course,
• your learning objectives for the course,
• how this course will impact / benefit your future studies of the Irish language.

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