Sponsor: Indiana Space Grant Consortium
Program: INSGC Masters Fellowship Program
Personal Information
| First Name: | |
| Last Name: | |
| e-mail: | sample-applicant@example.com |
| 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? |
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| 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. |
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Other Information
| Resume: |
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.
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| 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 |
(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.
| Ethnicity: | ||||
| Race: | ||||
| Birthdate: | ||||
| Person With Disability: | Yes No | |||
| Are You a Veteran: | Yes No | |||
Certification
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.