First Name: *
Last Name: * M.I.
Social Security #: *
Address: *
Address (cont.):
City: * | State: .. AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY* | Zip Code: *
Date of Birth (mm-dd-yyyy): ..010203040506070809101112- ..01020304050607080910111213141516171819202122232425262728293031- ....200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940
Gender:* Male | Female
Home Phone: - - *
E-mail Address: @ *
Name of High School:
Date of Graduation (mm-dd-yyyy): ..010203040506070809101112- ..01020304050607080910111213141516171819202122232425262728293031- ....20082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950
High School Average:
Student Status:
Freshman (1-25 credits)
Sophomore (26-60 credits)
Junior (61-90 credits)
Senior (91-120 credits)
Are you a Verrazano School student?* Yes | No
Are you a Macaulay Honors College student?* Yes | No
Are you a transfer student?* No | Yes | If yes, which school?
Declared/Intended Major: .. Computer Science Engineering Chemistry Biology Mathematics Bio-Chemistry Physics Information Systems *
Major GPA: | Cumulative GPA:
Please list any scholarship and fellowship awards (e.g. Merit, NYSHESC, previous STEAM support) (400 Characters Max):
Briefly describe any co-curriculum activities that have enhanced your preparation to study science technology, engineering, or mathematics (500 Characters Max):
Please check any that apply:
Employed Full-time
Employed Part-time
Supported by family
Other:
The following information is helpful in reviewing specialty scholarships. Please answer any that apply. This information is optional
Nationality:
Country of Origin:
Minority Status:
Immigration Status:
Number of Dependents:
Are you a single parent? Yes | No
Are you disabled? Yes | No
For which scholarship are you applying?*
Four Year Scholarship (incoming students and freshmen only)
Starting date: Expected Graduation date:
Starting date:
Expected Graduation date:
One-Semester Scholarship
For which semester?
Research Stipend
Research Type: Faculty Mentor: Project Title: Academic Session:
Research Type:
Faculty Mentor:
Project Title:
Academic Session:
In 500 words (maximum), please describe your intereston STEM (Science, Technology, Engineering, and Mathematics) and your goals in applying for a STEAM scholarship. Use the following questions as a guide.
When you are done with your essay, please submit it here:
Accepted files: Text (.txt), Wordpad (.rtf), MS Office Word documents (.doc, .docx).
Lastly, Are you a human being?
Before submitting, please check over your form for any mistakes.