Please Note: This is a sample application for viewing purposes only. To apply to this program please visit the application "New User Registration" page and register with the system.

Personal Information
First Name:
Last Name:
Current Address:
Congressional District:
To find your Congressional District visit the House of Representatives Website.
If your permanent home address is out of state please choose the congressional district for your school.

How did you hear about the INSGC Masters Fellowship Program?
Educational Information
University: At what Indiana Space Grant Consortium Affiliate university will you enrolled during the period of this award?
Degree Objective:
Expected Date of Graduation:
Educational History: 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 a degree. Please upload a PDF version of your transcript. If you are selected to receive the award, official transcripts will 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 Degree Date Awarded GPA
(4 pt scale)
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Letter of Recommendation
Confirm email:
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.
Other Information
File Upload
(PDF format)
Career Goals What are your short and long term career objectives (5 and 20 years)?
(300 words or less)
Answer one of the following two questions.
  1. What is the impact of the Space Program on your life?
  2. What is the impact of science, mathematics, engineering and technology on your life?
(400 words or less)
Honors and Societies Please describe any honors or awards that you have received and any societies that you are a member (includes dates and position held).
(300 words or less)
Have you previously received any other Indiana Space Grant Consortium funding?  Yes   No  
If so please describe the program and your experience.
(300 words or less)
NASA Alignment
Please indicate below how this work aligns with NASA's Mission Directorates
Aeronautics Research Mission Directorate

Human Exploration & Operations Mission Directorate

Science Mission Directorate

Space Technology Mission Directorate

Please describe how your work is aligned with NASA's Mission Directorates
(500 words or less)
INSGC encourages students to experience NASA-related research and career opportunities first-hand at NASA Centers or industry visits. Are you interested in receiving additional funding for expenses related to visiting a NASA Center or relevant industry (amount dependent upon location)?    
Optional Information
Students are strongly encouraged to provide the information requested below which is for reporting purposes only.
Person With Disability:Yes No
Are You a Veteran:Yes No
I am a citizen of the United States of America

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.

Please Note: This is a sample application for viewing purposes only. To apply to this program please visit the application "New User Registration" page and register with the system.