Maryland Space Grant Consortium - Scholarship Application

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Maryland Space Grant Consortium

2008-2009
Scholarship Application

The Maryland Space Grant Consortium was established in 1989 under NASA's National Space Grant College and Fellowship Program. One of the goals of the Maryland Space Grant Consortium is to offer financial support to Maryland residents or graduates of Maryland high schools who are enrolling as an undergraduate student in an affiliate institution who otherwise might not be able to attend college and who wish to pursue a career in math, science, engineering, technology, or a space related field. Awardees must be U.S. citizens enrolled as full-time students at a Maryland Consortium campus. Consortium campuses include: The Johns Hopkins University, Morgan State University, Towson University, University of Maryland-College Park, University of Maryland Eastern Shore, and Hagerstown Community College. Awards vary and must be used for the following educational expenses (tuition, books, fees and room and board).

APPLICATION REQUIREMENTS:
	Maryland resident or graduate of a Maryland high school.
	Full-time student majoring in (but are not necessarily limited to): the biological and life sciences, chemistry, geological sciences, physics and astronomy, engineering and computer science.
	Enrollment in an affiliate institution of the Maryland Space Grant Consortium
	Awards are for one year, but are renewable (on a competitive basis) upon maintaining a 3.0 G.P.A.
	U. S. Citizen
	Community service

DEADLINE:
	All application materials are due by May 15, 2008 to the Maryland Space Grant Consortium. Maryland Space Grant Consortium will then forward the application to affiliate institution selected by student applicant.

Part I: Student Information

Last Name:
First Name:
MI:
Address:
City:	State: Zip:
Home Phone:	Work Phone:
Social Security Number:
Birthdate:	(dd/mm/yy)
E-mail address:
Citizenship:	U.S. Permanent Resident/Alien
Intended College Major:

Part II: Providing your gender, race or ethnicity information is optional. Please be advised that such information is helpful to NASA to assess the effectiveness of this program in recruiting a diverse pool of applicants. If you choose to respond, the information provided will be maintained confidentially and will only be used for the Scholarship Program of the Maryland Space Grant Consortium.

Gender:	Male Female
If you wish to be identified with a particular ethnic group, please check all that apply:	African American, Black Mexican American, Chicano Native American, Alaskan Native (tribal affiliation) Native Hawaiian, Pacific Islander Asian American (country of family's origin) Puerto Rican Caucasian Hispanic, Latino Other (specify)
Part III: Education
Name of High School:
Graduation Date:
High School Address:
City:	State: Zip:

Part IV: Certification of High School Grads and Test Scores
Current GPA:	ACT Scores:
SAT I (Highest Score Achieved - if available)	Verbal Math Total
Special Skills, Hobbies, Interests:
General Activities: (extracurricular, athletics, arts, music, volunteer work, etc.) (include dates of participation and offices held)
Awards:

Part V: Personal Essay
How will a Maryland Space Grant Consortium Scholarship help you meet your educational/financial goals? (Short essay 200-500 words.)

Part VI: College Information

Intended Major:
Major Career Goal:
Expected Graduation Date:

Consortium Colleges Applied to
The Johns Hopkins University
Hagerstown Community College
Morgan State University
Towson University
University of Maryland College Park
University of Maryland Eastern Shore

Plan to Attend
The Johns Hopkins University
Hagerstown Community College
Morgan State University
Towson University
University of Maryland College Park
University of Maryland Eastern Shore

Part VII: Two Letters of Recommendation
Please provide the names, phone numbers, and e-mail addresses of the people who can provide a letter of recommendation. Examples for High School Students: Principal, Math, Science or other Teacher or a respected member of the community. Examples for College Students: Deans, Faculty, Advisor, or Teaching Assistant.

Name:

Title:

Phone:

E-mail:

Name:

Title:

Phone:

E-mail:

All the information contained in my application is factually correct and honestly presented. I acknowledge that this application and all required credentials submitted to the Maryland Space Grant Consortium, including school and college reports and all transcripts, are confidential and are not to be released to anyone except as allowed by applicable law. I recognize that the Maryland Space Grant Consortium Scholarship Committee reserves the right to deny this scholarship application.

I Agree:

Notice of Nondiscrimination Policy
The Johns Hopkins University does not discriminate on the basis of race, color, gender, religion, sexual orientation, national or ethnic origin, age, marital status, disability or veteran status in any student program or activity administered by the university or with regard to admission or employment. Defense Department discrimination in ROTC programs on the basis of sexual orientation conflict with this university policy. The university is committed to encouraging a change in the defense Department policy.

Questions regarding Title VI, Title IX, and Section 504 should be referred to the Office of Equal Opportunity and Affirmative Action Programs. (410) 516-8075.

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