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PHI ALPHA THETA

DOCTORAL SCHOLARSHIP APPLICATION - 2006

(For Phi Alpha Theta graduate student members working on a Ph.D. in History who have passed
general examinations no later than February 17, 2006)

Name_____________________________________________ Date_______________________

College/University______________________________________________________________

Email_________________________________________________________________________

Address_______________________________________________________________________

City/State/ZIP__________________________________________________________________

Date & Place of Birth____________________________________________________________

COLLEGES/UNIVERSITIES ATTENDED
Name of School Location Attendance Degrees&
Dates Dates Received

UNDERGRADUATE
Major________________________________ Cumulative GPA______________________

# of semester hrs in History _______ Cumulative GPA in History ________


Phi Alpha Theta initiation date _______ College/University_____________________________

Phi Alpha Theta activities_________________________________________________________

______________________________________________________________________________
Foreign language(s) in which you have: A fluent reading
knowledge_____________________________________________________________________
Fair reading knowledge __________________________________________________________

University of current graduate enrollment __________________________________________

Title of doctoral dissertation _____________________________________________________

_____________________________________________________________________________

Dissertation advisor ____________________________________________________________

Date passed comprehensive/general exams __________________________________________

Anticipated date of completion of the doctoral degree _________________________________

Name and institutional affiliation of three (3) individuals – including the dissertation advisor submitting
letters of recommendation:

1.____________________________________________________________________________

2.____________________________________________________________________________

3.____________________________________________________________________________

Applicants must submit all items listed below as a complete package to be considered for competition:
• Application (six copies)
Official transcripts (one official copy from the institution that conferred the baccalaureate degree
and from each institution in which graduate work was undertaken)
• Curriculum Vitae or resume (six copies)
• Writing sample (five pages, double-spaced)
• Letter of recommendation from each of the three individuals listed above (only the original)
• Dissertation prospectus of no more than three (3) double-spaced pages (six copies)

SEND TO:
Phi Alpha Theta History Honor Society
University of South Florida
4202 E. Fowler Ave SOC107
Tampa FL 33620-8100

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