Middlebury

 

Scholarship Nomination Permission Form and Waiver

Please review the information below, sign and return to Student Fellowships and Scholarships, first floor of Adirondack House.  Direct any questions you have to Arlinda Wickland, Peggy Burns, or Amy McGlashan, according to the scholarship or fellowship involved.

Please enter the name of the Scholarship for which you are applying.

1)

I understand that it is an honor and privilege to apply for Middlebury College’s nomination or award. I acknowledge that both my personal reputation and the reputation of the College can benefit from the manner in which I represent myself and Middlebury College. I will do everything within my control to safeguard my good name and that of Middlebury College throughout this award competition.

2)

Because fellowship programs expect students to uphold Middlebury codes of conduct, I agree to disclose to the fellowship office any disciplinary action to which I have been subject. This information will remain confidential within the fellowship office. I understand that the fellowship advisor will discuss with me whether a violation or sanction affects my ability to be nominated by Middlebury.

3)

A college nomination is contingent upon the willingness of the nominee to make revisions to the proposal and/or application based on Selection Committee recommendations. The Selection Committee reserves the right to rescind a nomination if at any point it is determined that the proposal, application, or behavior of the candidate falls short of Committee expectations to produce high quality work in a responsible manner.

4)

I waive my right to view faculty and institutional letters of recommendation or endorsement which are written for the purpose of this award competition.

5)

I understand that my transcript and academic information will be reviewed in relation to institutional letters of recommendation and endorsements and the applications for this award competition. I also give permission for Student Fellowships to request copies of my transcript(s) as a part of the application process.

6)

I give permission for Middlebury College to use my biographical information and photograph to publicize my nomination and/or receipt of this scholarship or fellowship both internally and through college media. I also consent to have a copy of my application and all supporting materials retained indefinitely in Student Fellowships and Scholarships. I understand that generic selections of my application essays may be shared with future nominees as examples.

7)

I certify 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.

8)

I certify 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.