Application for

Texas Section Project NExT Fellowship

Last Name:	____________________________	First Name:	____________________________
Current Employer:	____________________________
Work Address	____________________________
	____________________________
City:	____________________________	State:	_________________ Zip: _____
Number of Years with Current Employer:	____________________________
Work Phone:	____________________________	Home Phone:	____________________________
E-mail Address:	____________________________	Fax:	____________________________
Highest Academic Degree:	____________________________	Institution:	____________________________	Year:	______
Undergraduate Institution:	____________________________
Research Interests:	____________________________ ____________________________ ____________________________ ____________________________
Previous Employer:	____________________________
Describe courses you are currently teaching.	____________________________ ____________________________ ____________________________ ____________________________ ____________________________
Describe courses you have taught.	____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________

Application for financial support. Texas Project NExT Fellows will be supported for two years. Support includes travel expenses and lodging to the fall meeting (at SHSU) and the spring meeting, which occurs jointly with the meeting of the Texas Section of the MAA. Lodging support is for double occupancy, or half of your expenses if you choose to obtain a single room.

Gender: ____ Female ____ Male

Preferred roomate if desired (optional): ____________________________

Single room: _____ (I will be liable for half the costs)

Estimated expenses: Airfare: $ ____ Gas: $ _____ Lodging: $ _____ Car/Taxi: $ ______

Print and fill out this application form, and send it along with a statement of your teaching philosophy, and a current curriculum vitae to:

Dr. Jacqueline Jensen
Department of Mathematics and Statistics
Box 2206
Sam Houston State University
Huntsville, Texas 77341-2206

Phone: (936) 294-3517
Fax: (936) 294-1882
Email: jensen "at" shsu "dot" edu

Project NExT is sponsored by the Mathematical Association of America with support from the Texas Section of the MAA.

Document last modified 5/4/07.

Gender:	____ Female ____ Male
Preferred roomate if desired (optional): ____________________________
Single room: _____	(I will be liable for half the costs)
Estimated expenses:	Airfare: $ ____ Gas: $ _____ Lodging: $ _____ Car/Taxi: $ ______