2008 SPIE EDUCATIONAL SCHOLARSHIP APPLICATION FORM Deadline: 11 January 2008 Please submit all materials in English Note: All scholarship applications will be judged on their own merit based on the experience and education level of the individual student. High school (pre-university/secondary school) and 1st/2nd year college undergraduate, postsecondary students are encouraged to apply and will be judged relative to other applicants with similar educational backgrounds. Application Requirements High School, Pre-University, Secondary School Students Will receive a one-year complimentary (free) Student Membership Submit a Pre-College Membership Application Form with the scholarship application form (contact scholarships@spie.org for the pre-college form) Must be planning to enroll full- time in an optics, photonics, imaging, optoelectronics program or related discipline (please refer to Table below) at an educational institution for the full year beginning Fall 2008 Undergraduate, Post-Secondary, Graduate Students must be an SPIE Student Member must be enrolled full- time in an optics, photonics, imaging, optoelectronics program or related discipline (please refer to Table below) at an educational institution for the full year beginning Fall 2008 Non-SPIE Student Members must submit a Student Membership Form (spie.org/membership) including payment with scholarship materials. All Students Submit one completed 2008 scholarship application form (Word or pdf). Form also available at spie.org/scholarships. Submit a 450-word essay Have two letters of recommendation sent separately by recommender Must include the Annual Scholarship Award Report with application materials if reapplying. The 2008 application must show new activities from which a previous award was received No more than 10 pages of application materials will be accepted. Extra materials exceeding the 10-page limit will not be considered Incomplete applications will not be considered All application materials must arrive by close of business (Pacific Standard Time) on 11 January 2008. Please check one discipline that best applies to your area of interest. __ Astronomy __ Micro/Nano Lithography & Fabrication __ Biomedical Optics & Medical Imaging __ Nanotechnology __ Communications & Networking __ Optical Design & Engineering __ Defense & Security __ Remote Sensing __ Electronic Imaging & Signal Processing __ Solar & Alternative Energy __ Illumination & Displays __ Undecided __ Industrial Sensing & Measurement __ Other ____________________________________________ __ Lasers & Sources Personal Information Last (Family) Name First (Given) Name Mailing Address City Email Phone Number Middle Name (if any) State/Province Citizenship Zip/Postal Code Country Perm US Resident SPIE Member # SPIE USE ONLY App# Date recd Ref1 recd Ref2 recd Other materials Incomplete Page Name Educational Data Current Enrollment: High School/College/University (Please include contact information) Website URL for University Beginning Year Expected Graduation Date (month & year) Current College/University Major What degree are you currently pursuing: Associate Bachelor Master’s Doctorate Other? (Please list below) (Please place a check in the appropriate box) Degree(s) Received Name of College/University You will Attend During the 2007-2008 School Year (Please include contact information) Website URL for University Beginning Year Expected Graduation Date (month & year) College/University Major Reference Letters Two letters of recommendation are required. At least one of the letters should be from a faculty member who is familiar with your educational program. Faculty recommendations must be on institution letterhead. References should comment on your character and potential for leadership and/or for making a significant contribution to optics, photonics, imaging, optoelectronics, or related field. This can be based on specific examples drawn from your course work, projects, or activities. Each letter of recommendation must be signed and sent directly to SPIE by the person making the recommendation. Ref1 Name Institution Name Dept Name Telephone Ref1 Name Institution Name Dept Name Telephone Email Email High School/College/University Department Head Endorsement To the best of my knowledge, I hereby verify that the academic information and summary of school activities as submitted in this application are correct, and the applicant meets the application requirements. Endorser’s Name and Title (Please print) Telephone Complete Mailing Address Signature and Date Email Institution Name Page Name 1. How will you use the SPIE Scholarship if one is awarded to you (example: tuition, books or related expenses, travel to SPIE technical meetings; or as supplement to assistantship(s): 2. Essay Question - In 450-words or less describe your proposed course of study (thesis, etc.) related to optics, photonics, imaging, or optoelectronics. Relation to these areas should be directly shown. Describe your career objectives and how the award of an SPIE Scholarship would help you attain them. Comment on what you have achieved and learned through your studies and activities. 3. Educational Record, Activities, and Honors (list all that is relevant to optics, photonics, imaging or optoelectronics or related discipline) Page Name Applicant’s Certification/Permission to Release Information I hereby certify that all information submitted on this application is true and accurate to the best of my knowledge. By submitting this application, I authorize my college/university to make available to SPIE information concerning my academic records. I understand that falsification of any information on this application disqualifies me for any current or future SPIE scholarship. I also understand that all applications will be evaluated on educational achievement, related activities, and the essay submission, and that scholarships will be awarded based on merit. Submission of an application in no way guarantees that a scholarship will be awarded. I understand that my application will not be considered if it is incomplete or submitted after the 11 January 2008 deadline. Signature _________________________________________________________ Date _________________________________ To be eligible for consideration, Scholarship applications must reach SPIE by 11 January 2008 Submit materials to: Or via Express Courier: Or Email: Scholarships@SPIE.org SPIE Scholarship Committee PO Box 10 Bellingham WA 98227-0010 SPIE Scholarship Committee 1000 20th Street Bellingham WA 98225 For more information, contact SPIE: Tel: +1 360 685 5452 Fax: +1 360 647 1445 SPIE.org/scholarships