CHOOSE OHIO FIRST SCHOLARSHIP PROGRAM (COFSP) ENGINEERING ACROSS THE PIPELINE APPLICATION ✔ New Application Renewal Application Eligibility Requirements: Cleveland State University, Baldwin-Wallace, or Ursuline College Student, enrolled Fall 2015(*) US Citizen or Permanent Resident, Ohio Resident (**) Junior or Senior Undergraduate Student, Graduate Student, or Post Baccalaureate Student STEM (Science, Technology, Engineering, and Mathematics) major applying, or intending to apply, to a Graduate Program in Engineering at Cleveland State University. Grade Point Average of 3.0 or Higher Graduate Students with a GPA lower than 3.0 should submit results from a recent [not older than 2 years] Graduate Records Examination (GRE, www.gre.org ) to be eligible. Commitment to Choose Ohio First Scholarship Program Requirements Students on full scholarships are NOT eligible * To be considered full-time, students must be enrolled in 12 or more credits (8 or more credits for Graduate Students). Students enrolled part-time (6-12 or 6-8 credits) will receive the Scholarship in two installments (50% each term) Name First Current Address Middle Number and Street CSU Student ID Home Telephone No. Last DOB City State E-mail Address ( ) - Other No. Signature ZIP @ ( ) - Date Current Student Status Junior Senior Post-Baccalaureate Student Are you enrolled in an Accelerated MS Program? ✔ Graduate Student YES ■ NO Anticipated Graduation Date: Current Major(s) and Intended Post-Baccalaureate or Graduate Program: _________________________ (**) IMPORTANT NOTICE To be considered for the COFSP, applicants must complete the Free Application for Federal Student Aid (FAFSA), available at http://www.csuohio.edu/financialaid/apply/ A valid FAFSA must be on file with the Financial Aid Office by the application deadline. Any financial aid related questions should be directed to the Financial Aid Office at 216-687-5411 or campus411@csuohio.edu. Supported by the Ohio Board of Regents http://uso.edu/opportunities/partnership/chooseohio1st/index.php CHOOSE OHIO FIRST SCHOLARSHIP PROGRAM (COFSP) ENGINEERING ACROSS THE PIPELINE Current Financial Aid (Please explain any current financial support/work you are receiving. Please specify amounts) Research/Entrepreneurship/Co-op Experiences (Please list with brief explanation; attach additional sheets if necessary.) Would you be interested in a Career in Science Entrepreneurship in Ohio? YES NO If so, please consider applying to the Bioscience and Healthcare (Science Entrepreneurship) Other Application Requirements: Essay Please attach a one page essay describing how your past achievements, present study plans, and future goals fit within the Choose Ohio First Program. References [only for New Applications] Names and contact information [phone no. or e-mail] of two faculty for reference purposes. [Faculty members within the STEM disciplines are preferred] Transcript [only for New Applications] Please attach a copy of your transcript (unofficial copy is acceptable). Application Deadline April 24, 2015 Submit Application by mail (postmarked by deadline), in person, FAX, or electronically to: Engineering Across the Pipeline Program c/o COFSP Coordinator, Dean’s Office Fenn College of Engineering Cleveland State University 104 Stilwell Hall 2121 Euclid Avenue, Cleveland, Ohio 44115-2214 Voice: (216) 687-2557 FAX: (216) 687-9220 Questions: Contact Dr. Jorge E. Gatica, (216) 523-7274 or j.gatica@csuohio.edu To submit this form by electronic mail, save as a PDF document once filled, and E-mail the PDF as an attachment to: j.gatica@csuohio.edu Supported by the Ohio Board of Regents http://uso.edu/opportunities/partnership/chooseohio1st/index.php