Pennsylvania Space Grant Consortium Application System

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.

Note: Application is open to PSU University Park students only

Personal Information

First Name:
Last Name:
Penn State e-mail:	abc123@psu.edu
Alternate e-mail:
9-digit Penn State Student ID Number:
Local Mailing Address:
	Local Address City , Local Address State Local Address Zipcode
Permanent Address:
	Permanent Address City , Permanent Address State Permanent Address Zipcode
Birthdate:
	Do you qualify for economic hardship assistance? qualify for economic hardship assistance Yes Do not qualify for economic hardship assistance No
	How did you hear about the Undergraduate Research Internship Program (URIP)?

Educational Information

Major:
Minor (if applicable):
University:	Penn State - UP
College:
Department:
Current standing:	You are considered a first year student for this internship if you have 29 or fewer credit hours received from PSU (or transfered from any outside institution). We do not count AP credit hours in this calculation.
University GPA:	Required if you have completed at least one semester at your a University
High School GPA:	Required if you have not completed at least one semester at your a University
Transcript:	File Upload (PDF format) Please upload your university or high school transcript. If you have not completed one full university semester please upload your high school transcript. Official transcripts are not required.
Math Proficiency:	Name of the highest mathematics course completed: Grade earned in that mathematics course: Name any current math course(s) you are enrolled in at PSU:
Science Proficiency:	Name of the highest science course completed: Grade earned in that science course: Name any current science course(s) you are enrolled in at PSU:
	Are you a Schreyer Honors College Scholar? Honors Scholar Yes No

Essays

*Please note that you will be asked to disclose if and how you used AI software in your essay responses.

Based on your experiences and understanding of science and research, describe your perceptions of research and why you feel the URIP program will benefit you.
(200 words or less)

What previous experiences or skills do you have? (e.g. previous lab experience, special computer program familiarity, personal strengths or qualities)
(200 words or less)

Describe your future plans and goals. How will this internship help you succeed?
(200 words or less)

(Optional) Briefly describe a significant challenge that you have overcome during the pursuit of your educational goals. You may also use this space to discuss anything else that you would like us to consider when evaluating your application.
(200 words or less)

Research Laboratories

Please select 1-3 labs below in order of preference. We recommend selecting at least 2 labs that interest you. For a description of available participating labs, please visit https://sites.psu.edu/urip/labs/.

Please describe how you arrived at your laboratory rankings above.
(150 words or less)

AI Disclosure

In composing this application, AI software was used in the following way(s):
Select ALL that apply.
*This does not include spellcheck or grammatical help in word processing programs like Microsoft office word document or google docs.

AI software was used to collect background information used in my essays
AI software was used to help write portions of my essays.
AI software was used for mechanical or grammatical help in crafting my essays.
AI software was not used to compose my essays.
AI software was used to compose the entirety of one or more of my essays.
Other (please explain in the box below)

Certification

I certify that:

I am a citizen of the United States of America

I am or will be a full-time undergraduate student during the academic years 2025-2026.

If awarded a laboratory experience, I agree to provide PSGC information about my studies and/or employment on request beyond the term of the award. (This is part of a NASA requirement to track the long range effectiveness of the scholarship program.)

I authorize The Pennsylvania Space Grant to record on film, tape, and/or other media my image, name, likeness and presentation and to use these for educational purposes through such transmissions and distribution as radio and television broadcast, various other media of electronic distribution such as cable, internet, videodisc, cassette and satellite, non-theatrical film distribution and print. You may use my name, likeness and biographical information for promotion and publicity of the resulting publication.

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.