Texas Space Grant Consortium Application System

Please Note: This is a sample application for viewing purposes only. This application cycle is currently closed.

Personal Information

First Name:
Last Name:
e-mail:	sample-applicant@example.com
Alternate e-mail:
Birthdate:
Address:
City:
State:	Zip:
Text messaging:	Send applications updates via text message
Cell Phone:
Phone:	-
Federal Congressional District:	Find your Representative

Educational Information

University Information:	What Texas Space Grant Institution will you be attending in the Fall? Why is my university not listed?
Department:
University Standing as of 9/1/2023:
Expected Date of Graduation:
GPA:	Overall GPA: Major GPA:
Are you a past TSGC Scholarship recipient?	Yes No Most Recent Year

Educational History: List the universities that you have attended beginning with the most recent. Only list universities where you have completed at least 10 credits hours. 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	Credits Completed	Transcript
			File Upload
			File Upload
			File Upload
			File Upload

Experience & Goals

Briefly describe your past educational and research experiences in STEM (Science, Technology, Engineering, and Math).
(500 words or less.)

Briefly describe your future educational and career goals in STEM (Science, Technology, Engineering and Math).
(300 words or less)

Briefly describe leadership roles that you have held and describe experiences that best demonstrate your leadership abilities.
(300 words or less)

Provide information on any other experiences you have had that you believe will be an asset to this program.
(300 words or less)

Letter of Recommendation

Name:
Title:
Institution:
Phone:
email:
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 notices@spacegrant.net with these instructions.

Optional Information

(for reporting purposes only)

Gender:	Male Female
Ethnicity:
Race:	American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Do not wish to report
Person With Disability:	I do not have a disability I have a disability I choose not to disclose
	How did you hear about the STEM (Science, Technology, Engineering, Math) Columbia Crew Memorial Scholarship?
Are you a US military veteran?:	Yes No

Verification and Cirtification

Verification of U.S. Citizenship:	I am a citizen of the United States of America
Certification:	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.

Please Note: This is a sample application for viewing purposes only. This application cycle is currently closed.