Computer Science, Engineering, Mathematics Scholarship
Application Form
Name:__________________________________________ Date:_______________________
Address:________________________________________
_______________________________________________
Telephone Number:________________________________
Email:__________________________________________
Social Security Number:____________________________
Citizenship Status (check one): ( ) U. S. Citizen ( ) National ( ) Refugee Alien ( ) Permanent Resident Alien
California Resident: ( )Yes ( ) No
Undergraduates, have you submitted a Free Application
for Federal Student Aid (FAFSA)?
Submit the Completed Application Package (Scholarship Application Form, essay, letters of recommendation, and copy of FAFSA award letter ) to the CSEMS representative for your department listed below:
Computer Science
Computer Science, Engineering, Mathematics Scholarship
Essay Form
Type a brief essay discussing your professional goals and explaining why you should receive a CSEMS scholarship. Applicants are advised that evaluation of your scholarship application shall be based in part on content and composition of this essay.
I give California State University, San Bernardino permission to release this information to the NSF, if required.
I give California State University, San Bernardino permission to publicize my schoState University, San Bernardino permission to publicize my scholarship award should I be a recipient.
I understand that if I receive a scholarship, I must carry a minimum of 12 units credit each quarter for the duration of the scholarship.
I certify that the information provided on this application is complete and accurate.
___________________________________
Signature of Applicant
_______________________
Date
Computer Science, Engineering, Mathematics Scholarship
RecommendationLetter
(Non-Confidential)
Name of Applicant___________________________________ SS#_____________________________
1. How long have you known the applicant and under what circumstances?
2. How would you rate the applicant in comparison to all other students you have known in the past three years? (e.g., the upper 5%, 10%, 25, etc.).
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3. Why do you recommend the applicant for a scholarship? What qualities, personal characteristics, and interests does the applicant possess which make her/him outstanding among other students?
Signature________________________________________ Date__________________________
Print Name______________________________________ Title___________________________
School________________________________________________________________________
Computer Science, Engineering, Mathematics Scholarship
RecommendationLetter
(Non-Confidential)
Name of Applicant___________________________________ SS#_____________________________
1. How long have you known the applicant and under what circumstances?
2. How would you rate the applicant in comparison to all other students you have known in the past three years? (e.g., the upper 5%, 10%, 25, etc.).
5%, 10%, 25, etc.).
3. Why do you recommend the applicant for a scholarship? What qualities, personal characteristics, and interests does the applicant possess which make her/him outstanding among other students?
Signature________________________________________ Date__________________________
Print Name______________________________________ Title___________________________
School________________________________________________________________________