Northern Arizona University
College of Engineering, Forestry, & Natural Sciences (CEFNS)
TRANSFER-GEMS SCHOLARSHIP APPLICATION FORM
For the 2015-2016 Academic Year
This scholarship is only available to new transfer students
with an approved CEFNS major* and is supported by the
National Science Foundation under Grant Number 1260138.
*All CEFNS majors except Biomedical Science, Exercise Science,
Chemistry, pre-health professionals and Secondary Education.
Return completed application to Jen Johnson, Bldg. 21 room 13230or
email to Jen.Johnson@nau.edu by March 30, 2015 for priority
consideration. Questions? Contact:
Jen.Johnson@nau.edu or 928-523-5528
APPLICANT INFORMATION
Applicant name (last, first, middle initial):
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Date of Birth: Click here to enter text.
NAU ID #
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E-mail Address:
Current phone number:
Are you a member of a
Federally-recognized
Native American tribe?
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Click here to enter text.
☐ Yes ☐ No
Local Address:
If so, which tribe(s)?
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State: Click
ZIP Code: Click
City: Click here to enter
here to
here to enter
text.
enter text. text.
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ACADEMIC INFORMATION
NAU Intended Major:
Minor or emphasis (if
applicable):
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text.
Current GPA: Click here to enter text.
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School transferring from:
No. of Credits Transferring to
NAU:
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Other institutions attended:
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You are currently a:
☐ full-time student ☐ part-time student ☐ neither
High School Name, City, State:
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enter text.
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here to enter text.
High School GPA:
How many credit hours do you plan to enroll in during the academic year?
Have you completed college level
pre-calculus (MAT 125)?
☐ Yes
☐ No
Fall 2015:
Click here to enter
text.
☐ In-Progress
Have you completed college
level General Chemistry
(CHM 151/L)?
☐ Yes ☐ No ☐ In-Progress
Spring 2016:
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enter text.
BACKGROUND INFORMATION
Are you a first generation college student?
Are you a U.S. citizen? ☐Yes ☐No
☐ Yes
If no, list your Country of Citizenship:
☐ No
Are you an Arizona resident?
☐ Yes
☐ No
Have you completed a Federal Student Aid application
(FAFSA) for 2015-2016 academic year?
☐ Yes
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Do you plan to work during the academic year? ☐ Yes ☐ No Hours per week?
here to enter text.
Do you plan to complete your degree at NAU? ☐ Yes ☐ No ☐ Unsure
☐ No
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Northern Arizona University
College of Engineering, Forestry, & Natural Sciences (CEFNS)
TRANSFER-GEMS SCHOLARSHIP APPLICATION FORM
For the 2015-2016 Academic Year
ACADEMIC/PROFESSIONAL INTEREST
Please mark all Science, Technology, Engineering and Math (STEM) areas of interest. These interests must be included in your essay.
Civil Engineering
☐
Biological Sciences
☐
Environmental Engineering
☐
Chemistry and Biochemistry
☐
Electrical Engineering
☐
Physics and Astronomy
☐
Mechanical Engineering
☐
Mathematics and Statistics
☐
Computer Science
☐
Environmental Science
☐
Construction Management
☐
Geology
☐
Forestry
☐
Other:
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Do you plan to live on campus?
☐ Yes ☐ No
If yes, are you interested in participating in the Transfer-GEMS Residential Learning Community*? ☐ Yes ☐ No
Are you interested in participating in Transfer-GEMS academic and social events and activities?
☐ Yes ☐ No
*Living on campus in an upper-classman, suite-style residence hall with other Transfer-GEMS students
___________________________________________________________________________________________________________
Along with this application, please submit the following documents:
1.) Unofficial transcripts from all institutions from which you are transferring credit.
(Note: Official transcripts will be required at a later date)
2.) Completed questionnaire/essay (pages 3-4 of this application).
3.) One letter of reference from a faculty member or employer who is familiar with your work.
Only complete application packets will be considered for this scholarship.
The application deadline for priority consideration is March 30, 2015.
By submitting this Scholarship Application Packet, you are giving your consent for NAU to release your personal information to individuals who will be
considering you for this scholarship. This includes, but is not limited to, your application information, GPA, financial need, transcripts, etc. Also, should you
be selected to receive this scholarship, updates of your progress at NAU including GPA, classes taken, financial need, etc. will be required. Submission of
this application confirms that you agree to these terms and conditions.
If selected for this scholarship, I also agree to:
-be enrolled as a full time student (12 units minimum) each semester of award.
-participate in required Transfer-GEMS mentoring program and related activities each semester of award.
-meet 3.0 minimum GPA requirement each semester of award. Failure to meet this requirement will result in the discontinuation of scholarship award.
-participate in the College of Engineering, Forestry & Natural Sciences Awards Ceremony (if scheduled).
I have read and agree to the above terms and conditions.
Click here to enter text.
Student Signature
Print Name
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Date
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Northern Arizona University
College of Engineering, Forestry, & Natural Sciences (CEFNS)
TRANSFER-GEMS SCHOLARSHIP APPLICATION FORM
For the 2015-2016 Academic Year
TRANSFER-GEMS APPLICANT QUESTIONNAIRE
Applicant Name: Click here to enter text.
NAU ID: Click here to enter text.
Applicant Signature: _____________________________ Date: Click here to enter text.
As a required component of your Transfer-GEMS application, please answer the following
questions about your involvement and interests in science, technology, engineering and/or
math (STEM).
1. Please rate how easy it is for you to do the following tasks on a scale from 1 to 5, where 1 is not at
all easy and 5 is very easy.
a.) Draw a graph depicting the relationship between two variables
(for example, temperature and pressure).
Rating: Click here to enter text.
b.) Interpret a graph depicting the effect of more than one
Independent variable on an outcome (for example, the
effect of both temperature and rainfall on plant growth).
Rating: Click here to enter text.
c.) Design an experiment to test the effect of temperature on a
chemical or biological process such as decomposition of leaves.
Rating: Click here to enter text.
d.) Design and build a tool or structure.
Rating: Click here to enter text.
e.) Identify science questions in a news article.
Rating: Click here to enter text.
2. Please describe how your prior experiences (in school or in your extra-curricular life) have
influenced the ratings you just provided. If your ratings are different for different tasks, please
explain why you feel more confident about one task than another.
Click here to enter text.
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Northern Arizona University
College of Engineering, Forestry, & Natural Sciences (CEFNS)
TRANSFER-GEMS SCHOLARSHIP APPLICATION FORM
For the 2015-2016 Academic Year
3. How much time (on average) do you spend each week in the following activities? Please estimate to
the nearest hour (for example, 5 hours per week).
a) Attending science and math classes.
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b) Completing science and math homework on your own. Click here to enter text.
c) Completing science and math homework with others.
Click here to enter text.
d) Working on STEM projects in a club or as a hobby.
Click here to enter text.
e) Working on STEM projects in a volunteer or paid work setting. Click here to enter text.
4. Besides school, in what ways have you engaged in science, math, or engineering-related activities
(for example, clubs, hobbies, projects, reading, work)?
Click here to enter text.
5.) Please attach a double spaced essay (up to two pages maximum) describing your interest in
pursuing a Bachelor of Science (or higher) degree in a STEM major and your future career goals.
Please include your academic and professional interests, leadership qualities, work ethic and views
on the value, roles and responsibilities of your intended profession.
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