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LehighSiliconValley 2019 Application
Email address *
Applicant Information
First Name *
Last Name *
Middle Initial
Lehigh Email Address *
N/A if not a Lehigh student
LIN Number *
N/A if not a Lehigh student
Please select from the following *
Gender Identity *
Required
Street Address *
Apartment/Unit #
City *
State *
Zip *
Cell Phone *
Date of Birth *
(MM/DD/YYYY)
Essay, Resume, LinkedIn and Transcript
Short Essay: What value do you hope to gain from the program and your chosen track? What value will you bring to the program and your chosen track? *
This essay is how we will get to know more about you! Use it to tell us why you should be a part of this program, and what you will contribute to the cohort. Please keep your response to 500 words or less.
Upload Resume *
Required
LinkedIn URL
Current Copy of Advising Transcript (printed from Banner) *
Required
Track Preference Request
Please rank your track choices from 1 (your first choice) to 4 (your last choice). *
No pre-requisites are required for any track.
1
2
3
4
Arts & Entrepreneurship
FinTech
Software Engineering
Startup
Provide a short paragraph on why you chose your #1 track *
Education
Please select from the following: *
Graduation Year or Projected Graduation *
Are you an international student? *
If yes, please state what type of visa you have.
College or Institution *
Major(s) *
Minor(s)
Undergraduate or Cumulative GPA *
Financial Information
Do you qualify for tuition remission ? *
Lehigh University provides an undergraduate tuition remission benefit for eligible dependent children of full benefits eligible faculty and staff and their domestic partners.
Do you qualify for financial aid? *
If you are eligible for financial aid and would like to request financial aid for this program, please state the amount of financial aid you are requesting. There is no guarantee you will receive financial aid. Your request will be based on your 2017-2018 information already on file in the financial aid office. You must apply by the discount date of noon on October 12th, 2018 if you are requesting financial aid.
The required non-refundable deposit of $250 has been paid through Lehigh University's Bursar through the ebill suite. This system will be available starting September 10th. Deposit must be made before the October 12th deadline for the early discount and before October 22nd for all applications. In order to make your deposit you will need to log into the ebill suite. This is the online system used by the Bursar Office for student payments. There is a link on the Bursar web page. Parents (Authorized Users) can also make the deposits. Deposits may be completed via credit card or echeck. Once you or an Authorized User are logged in the following are the steps to complete the deposit.1.Select Deposits on the ribbon on the top 2. Select Winter Term from the drop down arrow and click select. 3. Select a Deposit will display - From the drop down arrow select "CBE Silicon Valley" and click select. 4. The Deposit Name, Term, and deposit amount will display for the user. Select the green continue if this reads Silicon Valley (If not go back and select the correct deposit) 5. Select your payment method from the drop down arrow and proceed to complete your payment. *
Other Information
Any Disability or Dietary Restrictions? *
Did you apply to LSV in a previous year? *
If you applied to LSV previously, please list the year(s).
How did you hear about the program? *
(select all that apply)
Required
Emergency Contact Information
Emergency Contact Name *
Relationship of Emergency Contact Person *
Emergency Contact Cell Phone *
Agreement, Disclaimer and Signature
Signed Student Understanding and Agreement *
Follow the link to download Student Understanding and Agreement: https://drive.google.com/open?id=1HjE2-aaMPdo7gT0Hzl5a_Xug6e9ttvmP
Required
I understand that this application, attachments and a LSV deposit of $250 to Lehigh University's Bursar through the Touchnet system are due by noon on October 22nd, 2018. The balance of $4,775 is due by noon on Monday, November 5th, 2018. Those who apply and pay the deposit by noon October 12th, 2018 will receive a $200 discount if accepted.Deposits were to be made as follows: In order to make your deposit you will need to log into the ebill suite. This is the online system used by the Bursar Office for student payments. There is a link on the Bursar web page. Parents (Authorized Users) can also make the deposits. Deposits may be completed via credit card or echeck. Once you or an Authorized User are logged in the following are the steps to complete the deposit.1.Select Deposits on the ribbon on the top 2. Select Winter Term from the drop down arrow and click select. 3. Select a Deposit will display - From the drop down arrow select "CBE Silicon Valley" and click select. 4. The Deposit Name, Term, and deposit amount will display for the user. Select the green continue if this reads Silicon Valley (If not go back and select the correct deposit) 5. Select your payment method from the drop down arrow and proceed to complete your payment. *
Electronic Signature: By typing your first name, last name AND the last four digits of your Lehigh LIN below you are digitally signing the Student Acknowledgement Agreement and Release linked in the description below. *
Please click the following link to access the Student Acknowledgement Agreement and Release: https://drive.google.com/open?id=1HjE2-aaMPdo7gT0Hzl5a_Xug6e9ttvmP
I certify that my answers in this application are true and complete to the best of my knowledge. *
Electronic Signature: By typing your first name, last name AND the last four digits of your Lehigh LIN below you are digitally signing your LSV2019 application. *
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