Texas Higher Education Coordinating Board
Houston Community College
Texas-Science, Technology, Engineering, and Mathematics (T-STEM)
Challenge Scholarship Program
2015
APPLICATION PACKET
(Updated 7/15/2015)
Texas-Science, Technology, Engineering, and Mathematics (T-STEM)
Challenge Scholarship Program
Houston Community College
1. INFORMATION FOR APPLICATION
1.1. Purpose of T-STEM Challenge Scholarship Program
The Texas Higher Education Coordinating Board (THECB) is seeking to award Grants to support development,
implementation, and maintenance of scholarships to selected qualified community and technical college students
pursuing degree programs in identified STEM programs at Texas public community and technical colleges. TSTEM grants will help to increase graduation of students enrolled in STEM and related degree and certificate
programs.
1.2. T-STEM Scholarships
HCC must award scholarships to eligible students for the 2015-2016 academic year, beginning with the fall
semester 2015.
HCC may award scholarships to eligible students in an amount not to exceed $2500.00 annually for a maximum
of two years of support. No T-STEM scholarship recipient may receive a T-STEM Scholarship for more than a
cumulative total of two academic years, depending on eligibility (Section 11). A scholarship awarded in a given
semester or year does not represent an entitlement to an award in a second semester or year.
1.3. Students Eligible to Receive T-STEM Challenge Scholarships
The intent of the selection criteria is to help with the selection of students that can be successful in the T-STEM
Challenge Scholarship Program, (i.e., students that show promise to graduate on time and either find employment
within a STEM field or continue their education after graduation).
1.4. Initial Scholarship Recipient
T-STEM Challenge Scholarships are merit scholarships, based on past and continued student performance in
specific instructional programs. Eligible Students receiving an initial T-STEM scholarship must:
•
•
Have graduated from high school with an average of at least a 3.0 GPA on a four-point scale in
mathematics and sciences courses (This is a statutory requirement, which applies regardless of a student’s
previous academic record or work experience.);
Be enrolled at HCC and self-declared in a T-STEM instructional program. T-STEM Instructional
Programs include a defined set of courses that lead to the award of either a certificate or an associate
degree in the following U.S. Department of Education Classification of Instructional Program (CIP) areas
using CIP coding:
11.00
14.00
15.00
26.00
27.00
40.00
30.01
51.00
51.06
51.08
51.09
51.10
51.11
51.18
51.23
Computer and Information Sciences and Support Services);
Engineering
Engineering Technologies/Technicians
Biological Sciences
Mathematics and Statistics
Physical Sciences
Multi/Interdisciplinary Studies, Biological and Physical Sciences
Health Services/Allied Health/Health Sciences, General
Dental Support Services and Allied Professions
Allied Health and Medical Assisting Services
Allied Health Diagnostics, Intervention, and Treatment Professions
Clinical/Medical Laboratory Science/Research and Allied Health Professions
Health/Medical Preparatory Programs
Ophthalmic and Optometric Support Services and Allied Professions
Rehabilitation and Therapeutic Professions
2 Texas-Science, Technology, Engineering, and Mathematics (T-STEM)
Challenge Scholarship Program
Houston Community College
•
•
Agree to work no more than 15 hours a week in chosen instructional program area or related field, or for a
business participating in the T-STEM Challenge Scholarship Program; and
Have a statement on file with the applicant institution indicating that the student is registered with the
Selective Service System as required by federal law or is exempted from Selective Service registration
under federal law.
Students should plan to be eligible for a continuing scholarship by completing a minimum of 30 semester credit
hours within the year.
Math and science scores from non-standard high schools must be converted to the standard four-point scale using
a reasonable conversion scale that captures the relative merit of the scores.
1.5. Student Eligibility Limit
An Eligible Student may receive a T-STEM Challenge Scholarship for a maximum of two academic years.
Semesters for which a scholarship is received do not need to be consecutive. HCC may give partial scholarships
for a portion of an academic year to an Eligible Student.
2. REQUIREMENTS AND APPLICATION FORM
•
Students who are interested in participating in the T-STEM Challenge Scholarship Program need to
complete the attached application form. Type or print legibly in black ink. Sign and date.
•
Attach high school transcripts indicating an average of at least 3.0 GPA on a four-point scale in
mathematics and sciences courses.
Send application packet including high school transcripts
to one of the managers listed below per chosen college.
Northwest College – Professor Branson Brade at Branson.Brade@hccs.edu
Southeast College – Professor Marion Foster at Marion.Foster@hccs.edu
Southwest College – Dr. Leena Sawant at Leena.Sawant@hccs.edu
Central College – Dr. Dongning Lu at Dongning.Lu@hccs.edu
Coleman College – Director Jeff Gricar at Jeff.Gricar@hccs.edu
Northeast College – Dr. Beverly Perry at Beverly.Perry@hccs.edu
Application Submissions Deadline: September 15, 2015
We will accept applications after deadlines until we award all available slots each semester.
For further information about the T-STEM Program contact Dr. Jackeline Gascon, Program Director at
Jackeline.Gascon@hccs.edu
Part I
Personal and Contact Information
1. Full Name _________________________________________________________________
(Last)
(First)
(Middle)
2. Student ID _____________________
3. Social Security Number _________________________ Date of Birth _________________
3 Texas-Science, Technology, Engineering, and Mathematics (T-STEM)
Challenge Scholarship Program
Houston Community College
4. Email address _________________________________________(required)
5. Gender
Male
Female
6. Permanent Address __________________
City __________
State ___________
Zip ___________ Phone __________________
7. Choose College/Campus ____________________________
8. Are you first generation college student? _________
Part II
Educational Information
1. From which high school did you graduate? ___________________
2. If you did not graduate from high school, do you have a GED? ____________If yes, Math and science scores
from non-standard high schools must be converted to the standard four-point scale using a reasonable conversion
scale that captures the relative merit of the scores. _______________
3. What is your declared major field of study? _______________. Select a CIP code based on your major ______
4. What four-year college or university do you plan to transfer to? __________________
5. If in college, what is your classification? (e.g., freshman, sophomore, junior, senior) __________________
Part III
Work History (STEM Field)
1. Are you currently employed?
Yes
No
•
•
•
•
•
•
Full-time
Part-time
If yes, where? and how many hours? ____________ and _________
Employer Name: _______________________
Company/Industry: ______________________________
Employer Phone Number: ___________________________
Job Title: ________________________________________________
Duties __________________________________________________
______________________________________________________________
____________________________________________________________________
_____________________________________________________________________
•
•
•
Supervisor Name: __________________________
Supervisor Phone Number: __________________
May we contact this employer: ________________
I certify that this information is complete and correct to the best of my knowledge. I authorize the T-STEM Challenge
Scholarship Program Committee to review my academic file at the high school and college that was last attended.
Signature ____________________
Date _____________
4 Texas-Science, Technology, Engineering, and Mathematics (T-STEM)
Challenge Scholarship Program
Houston Community College
SCHOLARSHIP CONTRACT
I, _____________________, understand that if the T-STEM challenge scholarship is awarded to me, I will enroll in and
complete the program. The amount of this scholarship is up to $2,500.00 annually for a maximum of two years of support.
Accepting this scholarship means that I agree to:
___ have graduated from high school with an average of at least a 3.0 GPA on a four-point scale in mathematics and
sciences courses (This is a statutory requirement, which applies regardless of a student’s previous academic record or
work experience.)
___ be enrolled at the HCC and self-declared in a T-STEM instructional program
___ no T-STEM scholarship recipient may receive a T-STEM Scholarship for more than a cumulative total of two
academic years, depending on eligibility (Section 11).
___a scholarship awarded in a given semester or year does not represent an entitlement to an award in a second
semester or year.
___eligible students must be enrolled at HCC, in good standing with the institution, and fulfill all the obligations
required by the T-STEM scholarship program.
___work no more than 15 hours a week in chosen instructional program area or related field, or for a business
participating in the T-STEM Challenge Scholarship Program
I further understand that if I do not abide by the above stated terms that I may be dismissed from the program. By signing
this contract, I am agreeing that it is a fair and binding agreement. I understand and agree to all terms of the contract and
will work to adhere to them.
____________________________________________________________________________
Awarded Applicant’s Signature
Date
____________________________________________________________________________
Selected Manager’s Signature
Date
____________________________________________________________________________
Jackeline Gascon, Program Director
Date
5 Texas-Science, Technology, Engineering, and Mathematics (T-STEM)
Challenge Scholarship Program
Houston Community College
SELECTIVE SERVICE STATEMENT
As a requirement of the T-STEM grant, eligible students receiving a T-STEM scholarship must have a statement
on file with the applicant institution indicating that the student is registered with the Selective Service System a
required by federal law or is exempted from Selective Service registration under the federal law.
“Almost all male U.S. citizens, and male immigrants living in the U.S., who are 18 through 25, are required to register
with Selective Service. Non-citizens who are not required to register with Selective Service include men who are in the
U.S. on student or visitor visas, and men who are part of a diplomatic or trade mission and their families. Almost all
other male non-citizens are required to register, including undocumented immigrants, legal permanent residents, and
refugees. The general rule is that if a male non-citizen takes up residency in the U.S. before his 26th birthday, he must
register with Selective Service.” Selective Service Website 2013
Please check your Selective Service status:
Not exempt
Exempt
You must attach proof of registration to this application.
I am exempt from registering for Selective Service because:
I am female
I am a male 26 years of age or older
I am in the U.S. on a student visa
I am in the U.S. on a diplomatic visa
Send application packet including high school transcripts
to one of the managers listed below per chosen college.
Northwest College – Professor Branson Brade at Branson.Brade@hccs.edu
Southeast College – Professor Marion Foster at Marion.Foster@hccs.edu
Southwest College – Dr. Leena Sawant at Leena.Sawant@hccs.edu
Central College – Dr. Dongning Lu at Dongning.Lu@hccs.edu
Coleman College – Director Jeff Gricar at Jeff.Gricar@hccs.edu
Northeast College – Dr. Beverly Perry at Beverly.Perry@hccs.edu
Application Submissions Deadline: September 15, 2015
We will accept applications after deadlines until we award all available slots each semester.
For further information about the T-STEM Program contact Dr. Jackeline Gascon, Program Director at
Jackeline.Gascon@hccs.edu
6