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Paradoxx Travel Scholarship Application for Space Camp/SCIVIS: Texas
Paradoxx is Jim Allan, PhD and KC Dignan, PhD. This scholarship is privately funded by us, 2 VI professionals. We believe in the power and importance of giving students a chance to develop their independence and leadership abilities. SCIVIS is one option, one that we think is important. Each year we make up to 3 travel scholarships available for students interested in attending Space Camp/SCIVIS.

This application is intended to be completed in two parts: by a VI professional and by the student. It is intended to assist in travel and is good for up to $500.

SCIVIS helps students see themselves as leaders; as an empowered person. It is expected and a requirement of this application that the student take a leadership role in completing this application. It is also expected that the student will “pay it forward” when s/he returns from Space Camp.

It is also expected that evidence of this activity will be 1) supervised and/or supported by either VI staff or family members and 2) evidence of completion will be returned by May 15 of the same school year unless previously requested. Failure to return information about the required activity may affect the eligibility of future students in the region and/or district.

We understand that the student’s responses will reflect her or his age and level of experiences. This, like Space Camp/SCIVIS, is a growth activity. Completing this application is intended to be part of the leadership experience that is at the core of the SCIVIS experience.

Section 1: To be completed by the VI professional.
VI Professional Name
Your answer
Are you a ...
Your School District and Region
Your answer
Email
Your answer
Email Address - again
Your answer
Phone
Your answer
Cell Phone
Your answer
Name of Applicant
Your answer
How long have you known this student?
Your answer
Is this the first time s/he went to Space Camp?
Your answer
If not, when and at what age did s/he go previously?
Your answer
Will you be supervising/supporting your candidate’s pay-it-forward activity?
If not, who will? Please include contact information for that person. (name, phone, email)
Your answer
Why do you think s/he is a good candidate for Space Camp? Please include your thoughts on what you think s/he will gain from the Space Camp experience?
Your answer
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