APPLICATION

FACULTY FELLOWSHIPS FOR STUDY IN A SECOND DISCIPLINE
Applicant Information
Name
Title
College / School
Home Department
Campus Address
Campus Email
Campus Phone
Proposed Study
Semesters Requested
Department, discipline or area of proposed study
Faculty with whom proposed coursework or study will be done
Will office or laboratory space in the host unit be provided Yes
No
Required Documents
The following documents are required and must be uploaded in the appropriate spaces below:
  • Curriculam Vitae
  • Plan of Study (see guidelines for required information)
  • Letters of support
Letters of support with electronic signatures constitute an endorsement of this proposal application. Department heads thereby indicate that they understand and concur with the arrangement whereby the applicant, if successful, will be given released time for the approved period of study. The home department or school will also assume the teaching responsibilities for the faculty member selected for this program. In the absence of other arrangements, successful applicants will retain office space in their home departments as well as other ordinary services and prerogatives.

The applicant hereby agrees to retain his/her normal faculty duties at Purdue for at least one year after the completion of his/her Faculty Fellow of Study in a Second Discipline. Otherwise, the applicant agrees to reimburse Purdue University for all expenses incurred by the University during the applicant’s enrollment in the Program, including salary, benefits, and the stipend associated with the Program.
I agree    :
Document size limits - 250 KB each.
Please upload as indicated below:

CV:

Plan of Study:

Department Head Letter of Support:

Host Faculty Member Letter of Support:

Additional Materials:
(All fields are required in order to process the registration sucessfully. Please click the SUBMIT BUTTON ONCE. It may take up to 60 seconds to process the application. Please be patient. Thank you.)