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CONTACT
GIVE
Supplemental Summer Funding Survey
Supplemental Summer Funding Survey
Supplemental Summer Funding Survey
Name
*
First
Last
UID
*
Email
*
Current Stage in Program
*
Stage 1 (Pre-Part I)
Stage 2 (Post-Part I and Pre-Part II)
Stage 3 (Post-Part II)
Will you be enrolled full-time in Fall 2019?
*
Yes
No
Were you or will you be on leave of absence during any of these academic quarters (check all that apply):
*
Fall 2018
Winter 2019
Spring 2019
Fall 2019
No leave of absence during the above-listed quarters.
Will you be receiving any of the following forms of support in Summer 2019 (check all that apply):
*
UCLA TA / GSR / Reader / Tutor or other ASE appointment
Other UC or UCLA Employment
Summer Fellowship Support
No UC or UCLA employment
If receiving one or more of the above forms of support, please describe.
If funding becomes available, I would be interested in the following type of support (select one):
Summer Institute Tuition Support
Summer Language Study Tuition Support
Summer "backstop" funding
If seeking tuition support, please provide the name of the institution and the course or program you would like to take.
If seeking tuition support, please provide the full tuition amount:
Is there any other information you would like the award committee to be aware of?
T H A N K    Y O U !