Department of Engineering Science
Sonoma State University
Application for a Keysight-BEST Scholarship for the Academic Year 2015-2016
(Deadline: August 21, 2015)
Name (Mr./Ms.)_________________________________Student ID#______________
Last
First
M.I.
Mailing
address_______________________________________________________________
P.O. Box or Number & Street
City/State/Zip
Tel. (____)___________or(____)____________Email__________________________
Last high school
attended___________________________________________________
Name
City/State/Zip
High school (i) graduation date______ (ii) GPA_____ (iii) SAT/ACT
score____________
List all colleges previously attended (if any) in sequential order, including SSU:
Institution
Date
Declared
Degree
Cumulative Major GPA
(attended
Major
Received
GPA
(Math, Physics,
or current)
Computer
Science & Engg.
courses)
SSU (if
applicable)
Career Objective (e.g. engineer, researcher, etc. or “undecided”)__________________
_____________________________________________________________________
Extracurricular interests and activities: ______________________________________
_____________________________________________________________________
_____________________________________________________________________
List membership in any club, organization, honor society or associations and your
contributions to it:
_____________________________________________________________________
_____________________________________________________________________