Spitzer Space Telescope Fellowship Program Application Form - 2005


1. Name ________________________________________________________________

2. Address _____________________________________________________________
           _____________________________________________________________
           _____________________________________________________________
           _____________________________________________________________


3. Telephone _________________ E-mail  _________________________________

4. Date of Ph.D. (month/year) _________ University _____________________

5. Thesis Title ________________________________________________________
6. Thesis Advisor ______________________________________________________

7. Proposed Host Institutions
1st Choice ______________________________ Research Advisor _____________
2nd Choice ______________________________
3rd Choice ______________________________

8. Proposed Research Title _____________________________________________
9. Proposed Research short summary (not to exceed 100 words):











10. Main Research Plan Category: 
    Observations ____    Archival ____    Theory ____    Other ____

11. Spitzer Observing Time Requested (hours): _________

12. List of Referees (names / institutions) who will email letters of 
reference directly to the SSC at fellows@spitzer.caltech.edu:

1. _____________________________________________________________________

2. _____________________________________________________________________

3. _____________________________________________________________________

Save completed form as a postscript, PDF, or plain ASCII text file, and 
email to fellows@spitzer.caltech.edu with the other application materials.