• Must be a U.S. citizen
• Must be currently enrolled in a Virginia Community College and have completed at least one semester of coursework (minimum of 9 credit hours) at time of application.
• Must be enrolled full-time, 12 credit hours, during award period (2024-2025)
• Must be majoring in a Science, Technology, Engineering or Math (STEM) program of study
• Must have a grade point average of at least 3.0 on a 4.0 scale
• Must expect to graduate no sooner than May 2025 or later

First 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
Current 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
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

Community College:	What Virginia Community College will you be attending in the Fall? 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
Campus:
Department:
Major:
Specialization/Certificate:
Degree Sought:	Associate Degree Associate Degree in Nursing Associate in Electronics Engineering Technology Associate in Engineering Technology Associate of Applied Business Associate of Applied Science Associate of Arts Associate of Arts and Sciences Associate of Arts in Teaching Associate of Business Administration Associate of Engineering Associate of Forestry Associate of General Studies Associate of Industrial Technology Associate of Nursing Associate of Occupational Studies Associate of Public Service Associate of Science Associate of Technology
Expected Date of Graduation:
How many college credit hours have you completed?
Current GPA:
Future Education Plans:	Do you plan to transfer to a four-year institution? Yes   No   If yes, would you like for us to email you scholarship information? Yes   No
Educational History:	Transcripts are required of all applicants to validate eligibility and to review during the selection process. Applicants are required to have documentation of completion of at least 9 credit hours of college coursework prior to applying. Beginning with the most recently attended, list the institution and related info for each transcript submitted. Please upload a PDF version of your Fall 2023 transcript and the final transcript from each institution. Submitted transcripts may be unofficial. 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 Degree Date Awarded GPA (4 pt scale) Transcript AA AS BA BA BBA BS AB Bachelors MA MBA MS MSE Masters JD MD PhD Doctorate File Upload AA AS BA BBA BS AB Bachelors MA MBA MS MSE Masters JD MD PhD Doctorate File Upload AA AS BA BBA BS AB Bachelors MA MBA MS MSE Masters JD MD PhD Doctorate File Upload AA AS BA BBA BS AB Bachelors MA MBA MS MSE Masters JD MD PhD Doctorate File Upload

Please describe your academic and career goals including your interest in STEM. Be specific.
(750 words or less)

Plan of Study (List of your intended coursework for summer 2024 and sophomore academic year 2024-2025). Be specific. Please list the names of your courses in semester order.
(750 words or less)

Have you previously participated in any other Virginia Space Grant Consortium programs or received any Virginia Space Grant Consortium funding?  Yes   No  

Resume:

File Upload (PDF format)

Faculty Advisor First Name: Last Name: Title: Institution: Department: Address: City: State and Zipcode: 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 Phone: email: email confirm:

Reference #2 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

Once you have submitted your application both of these individuals will received 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 Friday, March 15, 2024. (750 words or less)
Students are strongly encouraged to provide the information requested below which is for reporting purposes only.

	How did you hear about the VSGC Graduate Research Fellowship Program?
Gender:	Male Female
Ethnicity:	Hispanic or Latino Not Hispanic or Latino
Race:	American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Do not wish to report
Birthdate:
Person With Disability:	I do not have a disability I do not wish to identify my disability status Hearing Vision Missing Extremities Paralysis Other Impairments I have a disability, but it is not listed Specify if not listed:

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.