Checklist of materials needed to complete the application:

• Unofficial Transcripts
• Two References (at least one faculty or administrator)

• US Citizenship
• Be at least 18 years of age
• Attend a Virginia Community College
• Must be a sophomore not graduating prior to May 2024
• Taking a minimum of 6 credit hours
• Be a STEM major (Science, Technology, Engineering or Math)
• Minimum 2.5 GPA with references and activities demonstrating strong interest in STEM (NOTE: Students pursuing a technician track are encouraged to apply as well.)

First Name:
Middle Name:
Last Name:
e-mail:	sample-applicant@example.com
Alternate e-mail:
Address While at School:
	, AK AL AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY   - ZIP Code +4 Lookup
Text messaging:	Send applications updates via text message
Cell Phone:
Alternate Phone:
Permanent Address:
	, AK AL AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY - ZIP Code +4 Lookup

Current Virginia Community College:	Blue Ridge Community College Brightpoint Community College Camp Community College Central Virginia Community College Danville Community College Eastern Shore Community College Germanna Community College Laurel Ridge Community College Mountain Empire Community College Mountain Gateway Community College New River Community College Northern Virginia Community College Patrick & Henry Community College Piedmont Virginia Community College Rappahannock Community College Reynolds Community College Southside Virginia Community College Southwest Virginia Community College Tidewater Community College VA Peninsula Community College Virginia Highlands Community College Virginia Western Community College Wytheville Community College
School Address:
	, AK AL AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VI VA WA WV WI WY - ZIP Code +4 Lookup
School Phone:
Are you currently in a 2+2 program?	Yes   No   If you are transferring to a 4-yr, which university will you attend?
Academic Standing:	Sophomore Recently Received Associates Degree At the beginning of the Fall 2024
Degree Currently Pursuing:	Associates of Science Associates of Applied Science Associates of Arts
Expected Graduation Date:
Academic Major:
Are you in a technical track?	Yes   No
Cumulative GPA (including Fall 2023 grades):	out of 3.0 4.0 5.0 Other Please explain GAP scale.
Transcripts:	Please upload your unofficial transcripts as a single PDF file. Please make sure that your Social Security Number is NOT included as part of transcript information. File Upload (PDF format)

Do you have any relatives who work at NASA Langley Research Center or NASA Wallops Flight Facility? Yes   No  
Note: Students will normally not be assigned to work in the same organization as relatives. Please also note that your answers to the "relative" question will not be factored into the selection process, but instead will be used only by placement officials in the event a selection is made.

How did you hear about STEM Takes Flight?
Internet search STEM Takes Flight Program website Relative Conference, Career, or Job Fair My school's career planning office A friend or classmate A former intern My professor STEM Takes Flight program brochure Attended a STEM Takes Flight program briefing, teleconference, or webinar Saw it in a listing of internships Found it on Facebook Found it on another social networking site - Please specify NASA Employee E Newsletter Other - Please specify

Please list all courses that you have taken in community college. Include AP classes taken in high school. Please do not indicate "see resume or transcript".
Please list computer hardware & software capability: i.e.-MATLAB; and any certificates
Statement of Goals:
Statement of goals, research experiences, technician experience, and other pertinent data should be included. Provide a personal statement, not to exceed 2000 words, addressing your personal goals (e.g. associate's degree, technician track, bachelor's degree, graduate degree, career aspirations). A description of supplemental information is encouraged (e.g. previous experience, related activities). Please note any STEM-related school projects, work/volunteer experiences, or programs in which you have participated.
(Limited to 2000 words)
Scholarships, Fellowships, and Awards

Title	Location	Inclusive Dates

Academic Honors

Title	Inclusive Dates

List any NASA or Virginia Space Grant sponsored programs in which you have participated. (i.e. NASA Internships, Fellowships and Scholarships (NIFS), Virginia Aerospace Science and Technology Scholars (VASTS), Building Leaders for Advancing Science and Technology (BLAST), Virginia Space Coast Scholars (VSCS), Virginia Earth System Science Scholars (VESSS), Pathways Flight Academies (PFA), NASA Pathways, NASA Aero Academy, STEM Takes Flight, or Commonwealth STEM Industry Internship Program (CSIIP))

Program	NASA Center/Location	Inclusive Dates

Other Internships, Co-ops, Related Research Work

Company/School	Location	Inclusive Dates

Publications, Conference Proceedings, and Journal Articles Published (if applicable): Note: Additional citations may be listed on your resume.

Title of Article:
Author(s):
Journal/Proceedings/Etc.:
Volume and Page Numbers:
Date:
Title of Article:
Author(s):
Journal/Proceedings/Etc.:
Volume and Page Numbers:
Date:

Resume
Please upload a PDF copy of your resume. It should include education, relevant coursework, previous work or internship experience, significant accomplishments, and any other relevant information. (PDF format) To ensure that your resume is searchable by the system, please paste a text copy of your resume here.
Please provide the name, phone number, and e-mail address of two people who can be contacted to provide a letter of recommendation. One reference must be a faculty member or college administrator. Immediate relatives are discouraged as references. References provided may also be contacted by phone. Please confirm reference's email address before submitting application.

Name:
Phone:
email:
email confirm:
Relationship to you:
Name:
Phone:
email:
email confirm:
Relationship to you:

Once you have submitted your application, both of these individuals will receive an email requesting their supporting material. Your application will not be complete until this information has been received. Please inform both of these 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, March 25, 2024. Transportation and housing arrangements including but not limited to leases, rent payments, deposits, etc., are the sole responsibility of the student participants.
Enter initials acknowledging you have read and understand this statement. Enter Date:

Transportation: Students are strongly encouraged to bring their own vehicles, if possible. This provides more flexibility with regard to housing options as well as traveling locally while in the STEM Takes Flight Program.

Housing: At your request, Virginia Space Grant Consortium will share contact information among students who may want to pursue housing together. If interested in pursuing housing with other interns, please initial and date below providing permission to share your contact information.
Enter initials acknowledging you have read and understand this statement. Enter Date:

Choose Housing Option:
Find housing on my own.
Wish to be considered for housing at NASA Wallops Flight Facility lodging, if available.
Wish to be considered for corporate housing with NASA NIFS interns if avaliable.
Do you have veterans's status? Yes     No Note: Optional data will not be viewable by evaluator/researcher.

NASA requests the following information. Submission of this information is voluntary and will not be used for selection purposes. Students are strongly encouraged to provide the information requested below.

Gender:	Male Female Prefer not to disclose
Birthdate:
Are you the first family member to attend college?	Yes No Prefer not to disclose
Ethnicity:	Hispanic or Latino Not Hispanic or Latino Prefer not to disclose
Race:	American Indian or Alaska Native Asian* Black or African American Native Hawaiian or Other Pacific Islander** White Other Prefer not to disclose *This includes, Chinese, Indian, Japanese, or Korean **This includes any of the original peoples of Hawaii; the U.S. Pacific Territories of Guam, American Samoa, and the Northern Marianas; the U.S. Trust Territory of Palau; the Islands of Micronesia and Melanesia; and the Philippines.
Disability:	I do not have a disability I do not wish to identify my disability status Vision Missing Extremities Other Impairments I have a disability, but it is not listed Prefer not to disclose   Specify if not listed: Reasonable Accommodation Statement Federal agencies must provide reasonable accommodation to applicants with disabilities where appropriate. Determinations on requests for reasonable accommodation will be made on a case-by-case basis.

Please place a check in the box below indicating citizenship category:
U.S. Citizen
Naturalized Citizen and Dual Citizen of U.S. and another Country
Naturalized Citizen (No dual citizenship)

I certify that I am a citizen of the United States.

NASA will verify the citizenship of applicants. Non-citizens including permanent residents are not eligible. Applicants who hold Dual Citizenship may be required to provide additional information upon request.

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 this application.