Cabrillo College Engineering Scholarship S-STEM Application (Spring 2016)
Due: Tuesday, May 31, 2016 by 5:00 p.m. PST

This scholarship program is open to both recent high school graduates as well as current Cabrillo College engineering students.

To apply for the Engineering S-STEM Scholarship at Cabrillo, you must fill out and submit this form. In addition you must submit the following:

1. A 300-word personal statement describing your academic and career goals.
2. High school transcript(s) if you are currently in high school.
3. College transcript(s) if you have attended college.
4. Letter of Recommendation from a high school or college teacher.

Note that these additional documents can be uploaded at the end of this application OR you may submit this form then return later in order to access the 'upload' webpage (https://goo.gl/AINPUY).

Your application will be deemed incomplete if you have not submitted both the on-line form AND the additional documents listed above by the due date (Tue. 5/31, 5:00 pm).

Please read this before starting this application:
https://www.cabrillo.edu/academics/engineering/docs/NSF%20S-STEM%20scholarship%20student%20criteria%20and%20application%20process_2016_final.pdf

First Name *
Your answer
Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Are you planning on attending Cabrillo College during the Fall 2016 semester as a full-time student (12 units or more)? *
Are you currently still in high school? *
Are you currently a student at Cabrillo College? *
If you answered "yes" to the last question, please provide your Cabrillo Student ID #
Your answer
Please indicate your engineerng major or the engineering major you are most interested in pursuing or learning more about. *
Major - Other...
Your answer
What is your educational goal: *
(you can choose more than one)
Required
Present Address: *
(Street, Apt. #, City, State, Zip code)
Your answer
Best Permanent Address (this may be your parents address): *
(Street, Apt. #, City, State, Zip code)
Your answer
Home Phone *
(xxx - xxx - xxxx)
Your answer
Cell Phone *
(xxx - xxx - xxxx)
Your answer
Email Address *
Your answer
Re-type Email Address *
Your answer
Gender *
Ethnicity *
Required
Please check the line that matches your residency status: *
Are you currently receiving Financial Aid? *
Do you have or do you anticipate having unmet financial needs while attending college? Mark all that apply. *
Required
MATH COURSEWORK
Completed with C or better
Currently Enrolled in
deselect
High School Algebra I or equivalent
High School Algebra II or equivalent
High School Trigonometry
Math 4 (pre-calculus)
Math 5A or HS Calculus Course
Math 5B
Math 5C
Math 6
Math 7
PHYSICS COURSEWORK
Completed with C or better
Currently Enrolled in
deselect
High school physics or equivalent
Physics 10
Physics 11
Physics 4A
Physics 4B
Physics 4C
Physics 4D
CHEMISTRY COURSEWORK
Completed with C or better
Currently Enrolled in
deselect
High school chemistry or equivalent
Chem 2
Chem 3
Chem 5
Chem 1A
Chem 1B
Chem 12A
Chem 12B
ENGINEERING COURSEWORK
Completed with C or better
Currently Enrolled in
Signed up to take in Summer-2016
deselect
Engineering 1A -Surveying
Engr 3 - "How Things Work"
Engr 5 - "Intro to Engineering"
Engr 10
Engr 12
Engr 15
Engr 25
Engr 26
Engr 30
Engr 35
Engr 45
High school engineering course
COMPUTER SCIENCE COURSEWORK
Completed with C or better
Currently Enrolled in
deselect
CS 11 or CS 11M
CS 12J
CS 19
CS 20J
CS 21
CS 23 / Math 23
CS 24
CIS 70
CIS 72
CIS 90
Lsit all other SCIENCE (or STEM) courses that you have completed at Cabrillo or in High School:
Your answer
If you are in high school and have taken any AP (Advanced Placement) tests, please list them. If known, include your grade. Example: AP Calculus (3)
Your answer
WORK: Do you work? *
Where do you work?
Your answer
In what capacity do you work (i.e. what do you do)?
(laborer, customer service, secretarial, etc.)
Your answer
How many hours do you work per week during the school year?
Your answer
If you have unpaid family commitments each week, indicate the average number of hours per week you spend on these commitments.
NSF S-STEM Scholarship Information Document *
Have you read in detail the 3-page document including Student Selection Criteria, Application Process and Requirements. The document can be found here: https://www.cabrillo.edu/academics/engineering/docs/NSF%20S-STEM%20scholarship%20student%20criteria%20and%20application%20process_2016_final.pdf
SUBMITTALS:
We encourage all students to submit the following documents online using the link below. You may upload any file type but it is suggested that you upload PDF format files.

1. A 300-word Personal Statement describing your academic and career goals.
2. High school transcript(s) if you are currently in high school.
3. College transcript(s) if you have attended college.
4. Letter of Recommendation from a high school or college teacher.

https://goo.gl/AINPUY (Upload Link)

Make sure you return to this google form to submit this application.

If it is a hardship to upload documents using the link above, you may also submit all documents (Personal Statement, Transcripts, Letter of Recommendation) to wivaldez@cabrillo.edu by May 31, 2016 by 5:00 p.m.

If you choose to E-mail your documents please use this format for the subject line:
Subject: "SPECS_S16_First name_Last name"

You may also drop off documents to Windy Valdez in Room 812 - Cabrillo College (Aptos) by the application deadline.

You may also mail in documents using this address:

Cabrillo College
Windy Valdez, STEM Grants
Natural & Applied Sciences Division
Cabrillo College
6500 Soquel Dr. - Room #812
Aptos, CA 95003

Thank you for applying. Please use the space below to tell us anything not covered in this application.
Your answer
Please Note: Student Financial Aid records will be reviewed in order to verify that students selected for this scholarship have a demonstrated financial need (US Dept of Education rules for need-based FAFSA).
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