Sponsor: South Carolina Space Grant Consortium
Program: Palmetto Academy
Personal Information
First Name: | |
Last Name: | |
e-mail: | sample-applicant@example.com |
Address: | |
City: | |
State: | Zip: |
Phone: | - |
Curriculum Vitae/Resume: |
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(PDF format only) |
Educational Information
University: |
What South Carolina Space Grant University will you be attending in the Fall? |
Department: | |
Current University Standing: | |
Major: | |
GPA: | (4 Point Scale) |
Credit Hours: | |
University ID: | |
Transcript (Unofficial or Official): |
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Educational History: |
List the universities that you have attended not including the degree that you are currently working on. Please upload a PDF version of your transcript. If you are selected
to receive the award, official transcripts may 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 | Credit Hours | Transcript |
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What would be your probable field of study for this degree?
After completing your studies, where do you plan to work?
Research Project
Please List in order of preference your programs of choice. For a description of each lab please review the program website. | |
1st Priority: | |
2nd Priority: | |
3rd Priority: | |
4th Priority: | |
5th Priority: | |
6th Priority: | |
7th Priority: | |
8th Priority: | |
Essay: |
In your essay, include the following in 2 pages or less:
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Reference
Title: | |
Name: | |
Institution: | |
Department: | |
Phone: | |
email: | |
email confirm: |
Personal Information for office use only
Gender: | Male Female |
Birthdate: | |
Ethnicity: | |
Race: | |
Person With Disability: | Yes No |
U.S. Citizenship: | I am a citizen of the United States of America. Yes No |
First Generation: | Will you or your siblings be the first in your family to graduate from college? Yes No |
Free or Reduced Lunch: | Did you qualify for subsidized school lunch? Yes No |
Military Service: | Have you ever served in the U.S. military? Yes No |
Other Information
Photo Release: |
File Upload (PDF format)By uploading this Photo Release Form, you give NASA and the SC Space Grant Consortium permission to use your photo on the website, in marketing tools, and other public forums. Please do NOT submit a photo. Sign and upload the Photo Release Form. |
Information Release: | I give permission to NASA and the SCSG to post my full name and award type online. Yes No |
Certification: | I certify that all of the information in this application is correct and that I meet all of the eligibility requirements stated. Yes No |