Please print out and complete this form and return it with the other application materials to:
Chair, Grants Committee
Keats-Shelley Association of America, Inc.
Room 226, The New York Public Library
476 Fifth Avenue
New York, NY 10018-2788
Preferred Address (with phone, e-mail, and fax, if applicable):
Date of Ph.D. (received or expected):
Title of Project
Names, Addresses (with phone and e-mail) of two references:
REMEMBER: Please send four copies of your application, CV, project description, and bibliography.
If you are unable to print this Application form from this Website or have further questions about the awards, please contact Doucet Fischer, the Administrator of the Grants, Keats-Shelley Association of America, Inc., Room 226, The New York Public Library, 476
Fifth Avenue, New York, NY 10018-2788; phone: 212 764-0655; e-mail: email@example.com.