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Nomination Acceptance Form

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Nomination Acceptance Form

I understand that it is both an honor and a privilege to be nominated by the University of Chicago for a
national fellowship competition. I understand that this nomination is provisional and may be withdrawn at
any time if I do not make acceptable progress in the application process. I also understand that my
nomination will not be publicly announced until my official application has been submitted to the
awarding body.
I am also aware of the significant responsibility of holding University nomination, and I am prepared to
commit the time and energy required to submit a thorough and well-prepared application. I will
adequately research the programs and institutions to which I am applying, I will meet all institutional and
internal deadlines, and I will meet with the appropriate advisers to revise my application materials, if
needed.
By my signature below, I hereby waive my right to view faculty and institutional letters of
recommendation which are written for the sole purpose of this award competition. While copies of these
letters may be provided to me by the authors, I understand that this is only done as a courtesy by the
author and in no way affects this waiver.
As required under the Family Educational Rights and Privacy Act (20 U.S.C. 1232g; 34 CFR Part 99),
commonly known as FERPA, I hereby give permission for my grade point average (GPA), transcripts, and
individual course grades, to be used and discussed as part of faculty and institutional letters of
recommendation and endorsements and the applications for this award competition. I also give
permission for the College Dean of Students Office to request official copies of my transcript(s) as part of
the application process, as needed.
In addition, I grant permission for the University of Chicago to use my likeness, my biographical
information, and excerpts from my recommendation letters to publicize my nomination for this award and
my receipt of this award, should I be fortunate enough to be selected. I also consent to having a copy of
my application and supporting materials retained by the College Dean of Students Office and understand
that it may be made available to future applicants as an example for them to review as they prepare their
own applications.
By signing below, I also hereby certify that I have no pending disciplinary actions against me and that all
of the information I include in my application for this award, including listings of activities and awards,
research undertaken or planned, and personal statements or other essays, are my own work and are
accurate and honest to the best of my knowledge.

Signature
Name (Print)
Scholarship(s) to which I am applying
1116 East 59th Street
Chicago, IL 60637
Tel. (773) 702-8615
collegescholarships@uchicago.edu
http://frogs.uchicago.edu/fellowships

Date

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