Cattell

The James McKeen Cattell Sabbatical Award

Application Form

Please submit five copies of this form by December 1. Do not submit your vita in lieu of any portion of this form.
[Date of receipt___________________________________________]

Date_________________________________________________________________

1. Name in full________________________________________________________

2. Social Security Number_______________________________________________

Telephone number(s)___________________________________________________

3. Professional address_________________________________________________

_____________________________________________________________________

4. Home address_______________________________________________________

5. Age (optional)_______________________________________________________

6. Period for which support is requested___________________________________

7. Brief summary of the activities proposed in Item 13. Please include
an indication of where you will spend your leave.

_____________________________________________________________________

8. Education: Colleges and Universities attended:

College or University

_______________________________

Inclusive Dates

________________
________________

________________

Degree

______
______

______

Major

______
______

______

9. Academic honors_______________________________________________________________________________
10. Current employment--Please indicate institution, current rank,
specialization within psychology and beginning date of employment.________________________________________

________________________________________________________________________________________________

If you have had one, when was your most recent leave with pay?___________________________________________

________________________________________________________________________________________________

How was it funded?________________________________________________________________________________

11. Employment history. List and describe each previous full-time position,
starting with the most recent and covering either 10 years or the time back to your
graduate study, whichever is less. Part-time positions may be included it they are revelant.

________________________________________________________________________________________________
________________________________________________________________________________________________

________________________________________________________________________________________________

12. Attach a reasonably complete bibliography of your scholarly publications. List
separately, or identify by a code: empirical research studies (R); substantive reviews
of research literature or theoretical analyses (T); and book reviews (BR).

13. Plan for sabbatical period. On separate sheets at the end of this application
describe in not more than 3 double-spaced pages, what you plan to do during the
fellowship period in terms of study, research, writing, or other activity that will
contribute to psychology or improve your effectiveness as a psychologist. Indicate
where you plan to spend the followship period. Explain what an additional semester
will permit you to undertake that could not be done in a one-semester sabbatical.
The text of this statement, excluding references, must be no more than 3
double-spaced pages.

14. Professional references. Give the names and mailing addresses of two
professional persons whom you will ask to provide an evaluation of your work.
Send each of them a copy of the two-page memorandum for referees. Members
of the Cattell Fund Board of Trustees are ineligible to serve as references.

________________________________________________________________________________________________

15. Please calculate the estimated amount of the award requested taking into
account your current salary, fringe benefits and amount of support from you
employer. In many cases it is helpful it you show your calculations.

________________________________________________________________________________________________

___________________

(date)

________________________________________________

(your signature or typed name if sent by e-mail)

Instructions:
(1) Copy form from the Web site and insert/paste into a word document on your computer. Fill out the application form and send the completed application by e-mail or by regular mail to Dr. Christina L. Williams.

(or)
(2) Print a copy of the application from the Web site, fill out the application, and send by regular mail to Dr. Williams.
Send to:
Email: williams@psych.duke.edu
(or)
Mail to:
Christina L. Williams, Secretary
James McKeen Cattell Fund
Department of Psychology: Experimental
Box 90086
Duke University
9 Flowers Drive
Durham, NC 27708-0086
919-660-5638

For The James McKeen Cattell Fund Home Page, click on the file name http://www.unc.edu/depts/quantpsy/cattell.html
For the Cattell Fund History Page, click on the file name http://www.unc.edu/depts/quantpsy/catthist.html
For Cattell Fellowship Eligibility Requirements, click on the file name http://www.unc.edu/depts/quantpsy/cattelig.html
For an Institution Certification form, click on the file name http://www.unc.edu/depts/quantpsy/cattcert.html
For a memo concerning references, click on the file name http://www.unc.edu/depts/quantpsy/cattref.html
For names of prior Cattell Fellowship Recipients, click on the file name http://www.unc.edu/depts/quantpsy/cattrecip.html

The James McKeen Cattell Sabbatical Award

Application Form

Please submit five copies of this form by December 1. Do not submit your vita in lieu of any portion of this form. [Date of receipt___________________________________________]

8. Education: Colleges and Universities attended: College or University _______________________________ _______________________________ _______________________________

___________________ (date)

________________________________________________ (your signature or typed name if sent by e-mail)

Please submit five copies of this form by December 1. Do not submit your vita in lieu of any portion of this form.
[Date of receipt___________________________________________]

8. Education: Colleges and Universities attended:
College or University
_______________
_
_________________

___________________
(date)

________________________________________________
(your signature or typed name if sent by e-mail)