Astronaut outside Space Shuttle in orbit

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:
Middle Name:
Last Name:
e-mail:sample-applicant@example.com
Alternate e-mail:
Verification of US Citizenship: I am a citizen of the United States of America
Local Address:
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Permanent Address:
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Text messaging: Send applications updates via text message
Cell Phone:
Alternate Phone: ( ) -
Birthdate:
Residency: Oregon     Other
Educational Information
University: What Oregon Space Grant University will you be attending in the Fall?
Class Standing: As of December 2025
Major:
Expected Date of Graduation:
Cumulative GPA: (for all subjects, 4 point scale)
GPA within major: (4 point scale)
Transcript:
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(PDF Format)
An unofficial transcript printed from the student account of the college or university website is acceptable. Transcripts must be organized by term and must include the most current term. If you are selected to receive this award, official transcripts may be required for verification.
Other Supporting Materials
Resume:
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(PDF Format)
Letter of Intent: Includes the following:
  • Describe the Plan of Study for your STEM academic goals throughout your undergraduate program.
  • Express your interest in a space science/aerospace related career.
  • Briefly describe your skill sets and qualifications in context of this opportunity.
  • Describe how this opportunity would benefit you and contribute to your academic and career goals and objectives.
(Suggested length: One page or about 300-550 words)
Topic Description: Includes the following:
  • Present the research topic you have selected to review and provide an overview of the topic. Include why you are interested in evaluating the current knowledge base of this particular subject.
  • State how the topic substantively aligns with one or more of NASA Mission Directorate's top priorities and how it speaks to a specific, real-world challenge facing one of NASA's current missions or area of emphasis.
NOTE: Topics should be specific/narrow in scope. If selected for a STARR award, students should be prepared to offer insight into the contributions of the research and demonstrate interdisciplinary applications and how the research could potentially extend to other areas of science or engineering relating to NASA's top priorities and missions.

See Appendix A of the Program Guide. Agency Information and Strategic Framework.

(Suggested length: One page or about 300-550 words)

Faculty Advisor Statement of Support:
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Please upload a letter of support from your faculty advisor.
Reference (Optional)
Name:
Title:
Institution:
Phone:
email:
email confirm:
If you choose to include a letter of recommendation, once you have submitted your application this individual will received an email requesting their supporting material. Please inform this individuals that they will receive an email request from notices@spacegrant.net for this information on your behalf. The deadline for submission of reference letters is Monday, December 22, 2025.
Demographic Information
Gender: Female Male Do not wish to report
Ethnicity:
Race:







Disability:








Have you ever served in the U.S. military? Yes No

Where did you hear about this opportunity?
Certification
I certify that all information in this data sheet is true and complete to the best of my knowledge. I also authorize release of information as described in the program guidelines. I understand that submitting false information will disqualify me from participation in Oregon NASA Space Grant programs and opportunities.
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.