Sponsor: Alabama Space Grant Consortium
Program: Alabama Space Grant Consortium Scholarship Program
|Text messaging:||Send applications updates via text message|
|Permanent Home Address:|
|High School Name:|
|High School City/State/Zip||, -|
Please enter the U.S. Congressional District of your high school zip code". You may use this website to find your district: House of Representatives Website.
|Country of Birth:|
File Upload(PDF format)
The resume should include a short summary of education, training and accomplishments both inside and outside the educational world.
|Educator Scholar:||Are you applying to be a Teacher Educator Scholar? Yes No|
What Alabama College/University will you be attending in the Fall
|Academic Standing:||At beginning of next school year|
|Expected Date of Graduation:|
|After completing your studies, where do you plan to work?|
List the universities that you have attended beginning with the institution you are currently attending. Other than your current
institution, only list universities where you have received 10 or more credit hours. Please upload a PDF version of your transcript.
Official transcripts may be requsted for verification.
If you do not have a PDF conversion tool you can use one of these free on-line PDF converters: PDF Online - PDF Converter.
To ensure that your PDF files may be properly included in your application, please ensure that they are not protected via encryption, a password, a signed certificate, or in any other manner.
|Please describe your short and long term career goals (5 and 20 years).
(500 words or less)
|Proposed Start Date:|
|STEM Outreach Statement||In your own words, describe your past educational and research experiences in STEM (Science, Technology, Engineering, and Math). Include any leadership roles that
you have held and describe experiences that best demonstrate your leadership abilities. While describing your leadership abilities include how you
could use these for K-12 outreach (500 words or less).
|Gender:||Male Female Do not wish to report|
Specify if not listed:
How did you hear about the Alabama Space Grant Consortium Scholarship Program?
|Person With Disability:||Yes No|
|I am a citizen of the United States of America|
|I certify that I am or will be a full-time undergraduate student at one of the ASGC universities.|
|I certify that all of the information contained in this application is complete and correct and that I meet all of the eligibility requirements stated in this application.|