DEPARTMENT OF BIOLOGICAL SCIENCES
Academic year_2013__
Your name ____________________________ Email _____________________________________
Address_________________________________________________________________________
Phone # _______________________________ Student ID # ______________________________
City___________________________________State________________Zip___________________
Major concentration______________________
Eligibility Requirements:

Be a CSUS Biological Sciences undergraduate major or graduate student,

Be enrolled full time in the semester in which the award is used.
This completed application and the following documents must be received in the Department of
Biological Sciences Office (SQU 202) no later than 12:00 Noon Friday, March 15, 2013:
1. A Statement of Purpose. Why do you think you deserve this award? What are your achievements (e.g. academic excellence, awards, leadership roles, job success)?
What challenges have you faced (e.g. academic, personal, financial, physical)?
Limit to one page.
2. CV/Resume. Include employment history, extracurricular activities, community service.
3. All transcripts (copies are acceptable). Upon request, the Department can access your
CSUS transcripts.
4. Completed recommendation form from two individuals. One of these individuals must be a
CSUS faculty member. The completed form may submitted by the recommender or in a sealed envelope with the application packet.
5. Completed Check-off sheet.
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Department Action:
_____________________________________________________________________________
_____________________________________________________________________________
Date received_____________________________