Chi Sci Scholars Application Form (NSF S-STEM)

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CSU Chi Sci Scholars Program (S-STEM)

Chicago State University
Chemistry and Physics
9501 S King Drive- SCI 309
Chicago, IL 60628
Phone: 773-995-2171
Fax: 773-995-3809
www.csu.edu

Kristy Mardis, Director, kmardis@csu.edu
Mel Sabella, Co-Director, msabella@csu.edu

Background

Objectives:
Increase the educational attainment of CSU students
Encourage more students to think of themselves as “scientists”

To accomplish these objectives CSU CSS Scholars will
- receive tuition support at CSU,
- engage in a summer program and weekend retreat,
- participate in early research experiences,
- engage in a mentoring program,
- attend conferences and present research,
- explore graduate programs, teaching careers, and careers in scientific research.

... the CSU SSTEM Program is supported by a grant from the National Science Foundation.

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* 1. Enter your Demographic Information:

Name:

Address:

Address 2:

City/Town:

State:

ZIP:

Country:

Email Address:

Phone Number:

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* 2. Current Status

Other (please specify)

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* 3. Please confirm that you meet the following criteria:

Students must be
(1) United States citizens, lawful permanent residents, or aliens admitted as refugees at the time they apply for the program;
(2) will be enrolled fulltime in a CSU chemistry or physics undergraduate degree program in each semester during which support is sought.
(3) a new student at CSU during the current academic year (Fall or Spring)

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* 4. Indicate the year and semester you plan to attend CSU.

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* 5. Please confirm that you meet one or more of the following criteria regarding financial need by clicking all that apply.

I qualified for free or reduced lunch in high school.

I qualify for a Pell grant

I aged out of the foster home system

I (or my family) qualify for food stamps

I (or my family) qualify for the Program for Aid to Families with Dependent Children

I (or my family) qualify for public aid

I (or my family) qualify for Illinois LINK

I come from a family with an annual income below a level which is based on low-income thresholds according to family size published by the U.S. Bureau of the Census - see http://www.census.gov/hhes/www/poverty/data/threshld/index.html

I do not meet any of the criteria listed above.

I am not sure if I meet these criteria.

Other (please specify)

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* 6. Please provide the name of the school you attended prior to joining CSU (HS/College/University).

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* 7. Science Field(s) you are interested in majoring in at CSU:
(*Note: the S-STEM program is for chemistry or physics majors only - in any of our options.)

Biology

Chemistry

Engineering

Physics

Environmental Science

Earth Science / Astronomy

Other (Explain below.)

Other (please specify)

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* 8. Current GPA (on a 4 point scale):
(Include your high school GPA if you are a freshman; Include your college GPA if you are a transfer student.)

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* 9. In an essay of approximately 500 words, explain why you are interested in pursuing science, science teaching, or engineering physics.

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* 10. Please provide the following information for the two individuals who are providing letters of reference.

Letters of reference should be sent directly from your references to Dr. Kristy Mardis (kmardis@csu.edu) via email. All letters should be on letterhead and must arrive before the application deadline. At least one of the letters should come from a HS or College Instructor who can comment on your commitment to academic success. In addition, letters should also comment on your leadership and service activities.

Reference 1 Name:

Reference 1 Email address:

Reference 1 Phone number:

Reference 1 Title:

Reference 2 Name:

Reference 2 Email address:

Reference 2 Phone number:

Reference 2 Title:

Email a copy of your transcripts from your previous school (HS or College) to kmardis@csu.edu. Transcripts can be unofficial.

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* 11. Checklist. Please confirm that you have completed the following before submitting.

All required information on this application form has been included.

I will be sending my unofficial transcripts before the application deadline.

I will contact my references and ask them to email their recommendations to Dr. Mardis by the application deadline.

I understand that this Scholarship is for new CSU students who are planning to major in Chemistry or Physics at CSU (includes: majoring in chemistry, physics, chemistry or physics teaching, biochemistry, engineering physics, physics for biosciences, etc.)

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* 12. How did you hear about the CSU NSF Chi Sci Scholars Program?

Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.

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NSF Logo

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* 1. Enter your Demographic Information:

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* 2. Current Status

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* 4. Indicate the year and semester you plan to attend CSU.

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* 5. Please confirm that you meet one or more of the following criteria regarding financial need by clicking all that apply.

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* 6. Please provide the name of the school you attended prior to joining CSU (HS/College/University).

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* 7. Science Field(s) you are interested in majoring in at CSU:(*Note: the S-STEM program is for chemistry or physics majors only - in any of our options.)

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* 8. Current GPA (on a 4 point scale): (Include your high school GPA if you are a freshman; Include your college GPA if you are a transfer student.)

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* 9. In an essay of approximately 500 words, explain why you are interested in pursuing science, science teaching, or engineering physics.

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* 11. Checklist. Please confirm that you have completed the following before submitting.

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* 12. How did you hear about the CSU NSF Chi Sci Scholars Program?

* 7. Science Field(s) you are interested in majoring in at CSU:
(*Note: the S-STEM program is for chemistry or physics majors only - in any of our options.)

* 8. Current GPA (on a 4 point scale):
(Include your high school GPA if you are a freshman; Include your college GPA if you are a transfer student.)