North Carolina Space Grant

University:

What North Carolina institution of higher education will you be attending in the Fall?

Major:

Second Major/Minor:

University Standing as of Spring 2024:

Expected Date of Graduation:

GPA:

(4 Point Scale)

Educational History:

List the universities that you have attended beginning with the most recent. Only list universities where you have completed at least 10 credits hours. 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	Credits	Transcript
Most Recent			File Upload
Previous			File Upload
Second Previous			File Upload
Third Previous			File Upload

What is the highest degree you would like to attain in the future?

What would be your probable field of study for this degree?

First Name:
Last Name:
e-mail:	sample-applicant@example.com
Alternate e-mail:
Address:
	CityState , - ZIP Code +4 Lookup Zipcode+4
Text messaging:	Send applications updates via text message
Cell Phone:
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.
Verification of U.S. Citizenship:	I am a citizen of the United States of America

	Research Mentor
Name:
Title:
Institution:
Department:
Address:	Address Line 2
City:
State and Zipcode:	State
Phone:
email:
email confirm:

Title:
	Research Interests, Goals, and Anticipated Findings. In your own words describe the research project that you will be conducting. The description should include but not be limited to a description of the research, start and end dates, anticipated results, and how you will be working with your research mentor for the term of the award. (1500 words or less)
	Alignment of Research to NASA Mission Directorates and the NC Space Grant Strategic Plan. Identify which NASA Mission Directorate that your research projects aligns with and describe how your research will contribute to the mission of that Directorate. Describe how your research project supports the NC Space Grant mission and strategic plan. (400 words or less) Primary NASA Mission Directorate Alignment: Secondary NASA Mission Directorate Alignment:
	Academic and Career Interests. Describe your career interest and how this research project supports the pursuit of your academic and/or career interests. (400 words or less)
	Intended Impacts of this Award. Describe how this research project will be a springboard to pursuing your future academic and/or career interests. What new skills or information will you obtain that will impact your pursuits? (400 words or less)
Project Location and Term
	My research mentor has read and approved this project description and has agreed to supervise me while I conduct this research.
	I understand that my research mentor will ask me to report on my research activities at the end of the academic year.

Gender:	Male Female
Ethnicity:
Race:	American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Do not wish to report
Birthdate:
Person With Disability:	I do not have a disability I have a disability I choose not to disclose
Birthdate:
	How did you hear about the NC Space Grant Undergraduate Research Scholarship Program?