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

Applications Due: Thursday, August 28, 2014
Frequently Asked Questions
Personal Information
First Name:
Middle Name:
Last Name:
Preferred Name:
Email:sample-applicant@example.com
Address:
,  
Home Phone: ( ) -
Cell Phone: ( ) -
Are you a US Citizen?   
What country were you born in?:
Are you currently enrolled in a two year college?   
Are you at least 18 years old?   
Are you a male or female student?   
School Information
School Name:
School Address:
,
Intended Major:
Transcript:
(PDF format only)
Please upload a copy of your most recent official or unofficial transcript. If your Social Security Number appears on the transcript please back it out prior to uploading.

To enable your files to 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.

Recommendation Letter As part of your application packet you are required to provide one letter of recommendation from a teacher, school administrator or someone who an attest to your academic qualifications.
Name:
Title:
Institution:
Phone:
email:
email confirm:
Once you have submitted your application, the system will email this person 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 notices@spacegrant.net with these instructions.

Note: It is the responsibility of the student to follow up with the person who is providing a letter of recommendation to ensure the recommendation is submitted electronically by the Saturday, August 30, 2014 deadline.
Legislative District Information Look up your U.S. Congressman or Congresswoman
Congressman or Congresswoman's Name:
District:
Other Information Why are you interested in attending this NASA experience?
(300 words or less)
Optional Information Students are strongly encouraged to provide the information requested below. This information is collected for federal reporting purposes only and is not accessible to the program's selection panel.
Ethnicity:
Race:
Person With Disability:
Student Certification
By applying to the project, you are acknowledging the following:
  • The responses submitted on this application are true, complete, and correct to the best of my knowledge and belief and are made in good faith. I understand that a knowing and willful false statement on this application will forfeit my participation in the project.
  • Release of name, mailing address, and school to U.S. and/or State Senators and Representatives, if selected to participate.
  • Release of name, college, city, and state for purposes of project participation press releases, if selected to participate.
Please Note: This is a sample application for viewing purposes only. This application cycle is currently closed.