NASA SPACE GRANT First Tech Challenge Scholarship Application
Only United States Citizens are eligible
Application must be typed.
Project Applicant
Student ID:
Project Title: FTC Robot Design Team
First, Middle, Last Name:
T-shirt size: Small
Medium
Primary Email:
Large
X-Large
XX-Large
Secondary Email:
Standing: Freshman
Sophomore
Junior
Senior
Grad Student
Major:
Minor (Second Major):
Hometown Congressional District:_
(see map at end of document)
GPA:
Faculty Advisor:_
Future Plans (Required--Select one):
Higher Education
Faculty
Administrative
Other
Student Demographics: Optional
Race: African American
Asian
Caucasian
Private Industry
Hispanic
Teaching (K-12)
Native American
NASA
Pacific Islander
Non-NASA Federal Agency
Other
State/Local Government
Gender: Female
Nonprofit Organization
Male
Military
Person with Disability: No
Consulting
Yes
Undecided
Other
Specify:
Student ID: ______________________
Write a paragraph describing why you want to be a member of the robotics team and the skills you possess that
will make you a valuable team member.
Student ID: ______________________