NASA WV Student Ambassadors

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.

Personal Information
e-mail:sample-applicant@example.com
- ZIP Code +4 Lookup
Text messaging: Send applications updates via text message
Cell Phone:
Educational Information
College/University: Which affiliate of West Virginia Space Grant are you currently attending?
Major Field of Study:
Overall GPA: (4 point scale)
Current Rank:
Expected Date of Graduation:
Are you currently a member of any STEM related student organization such as WV SPOT, S.P.A.C.E, AIAA, etc? Yes    No
   If yes, please list the organizations.
Other Items
Essay: A one-page essay describing why you want to be an ambassador and what/how you would promote NASA opportunities at your university.
File Upload
(PDF Format)
Resume:
File Upload
(PDF Format)
Unofficial Transcript:
File Upload
(PDF Format)
Optional Information
For reporting purposes only
Gender: Male Female Non-Binary Do not wish to report
Ethnicity:
Race:







Person With Disability: Yes No I don't wish to report
US Veteran: Have you ever served in the US armed services? Yes No
Birthdate:
Verification
I am a citizen of the United States of America.
I have a valid drivers license.
If awarded, I agree to provide West Virginia Space Grant Consortium: (1) an end-of-year report detailing my activities and accomplishments during the period of the Fellowship, including publications, research, and meetings attended; and (2) 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 certify that all of the information contained in this application is complete and correct and that I meet all of the eligibility requirements for this program.
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.