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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:
CityState ,   - ZIP Code +4 Lookup Zip CodeZip Code + 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
Educational Information
University: What North Carolina institution of higher education will you be attending in the Fall?
Second Major/Minor:
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)
Most Recent
File Upload
File Upload
Second Previous
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Third Previous
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What is the highest degree you would like to attain in the future?
What would be your probable field of study for this degree?
After completing your studies, where do you plan to work?
Letter of Reference
Address Line 2
State and Zipcode: State Zipcode
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. The deadline for submission of reference letters is Wednesday, October 18, 2023.
What courses and other activities do you plan to enroll in? How will these activities enhance your STEM-teaching capabilities?
(500 words or less)

Briefly describe your educational philosophy or particular interest in your approach to teaching STEM.
(500 words or less)

How will this award impact you personally and professionally?
(300 words or less)

Optional Information
Students are strongly encouraged to provide the information requested below which is for reporting purposes only.
How did you hear about the STEM Pre-service Teacher Education Scholarship Program?
Gender: Male Female

Person With Disability:

If I receive this award I will:
  • Participate in a welcome webinar that will provide an overview of NASA resources
  • Complete four virtual NASA professional development webinars (scheduled throughout the academic year)
  • Complete two NASA lessons and participate in two share-a-thon webinar sessions to discuss best practices and cross-curricular connections
  • Respond to academic and employment follow-up surveys administered as required by the federal government.
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 the program announcement.
Please Note: This is a sample application for viewing purposes only. This application cycle is currently closed.