Please Note: This is a sample application for viewing purposes only. This application cycle is currently closed.

Personal Information
First Name:
Last Name:
Alternate e-mail:
Current Address:
Cell Phone:( ) -
Permanent Address:
Educational Information
University: Choose the Delaware Space Grant Consortium institution you will attend in the fall:
September 2024 University Standing: As of September 2024
Educational History: List the universities that you have attended beginning with the most recent. Only list universities where you have completed at least 10 credit hours. Please upload a PDF version of your transcript. If you are selected to receive the award, official transcripts may be required 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.
College/University Major Credits Completed Transcript
File Upload
File Upload
File Upload
File Upload
Letter of Recommendation
A letter of recommendation from Department Chairperson, DESGC Consortium Representative and/or Advisor.
email confirm:
Once you have submitted your application we will email them instructions on how to submit an on-line letter of recommendation on your behalf. Please inform them that they will be receiving an email from with these instructions.
A statement from applicant describing completed academic work and career plans indicating how these relate to NASA's mission to drive advances in science, technology, and exploration to enhance knowledge, education, innovation, economic vitality, and stewardship of earth. (Limited to 600 words)
Other Information
The following information is for reporting purposes only.
Gender: Male Female Do not wish to report


  Specify if not listed:

How did you hear about the NASA Delaware Space Grant Undergraduate Tuition Award?
Person With Disability:Yes No Undisclosed
I am a citizen of the United States of America
I understand that an award in this program is contingent upon the applicant's acceptance into a STEM-related undergraduate program at a Delaware Space Grant member institution.
I certify that all of the information contained in this application is complete and correct and that I meet all of the eligibility requirements for this program.
Please Note: This is a sample application for viewing purposes only. This application cycle is currently closed.