2005 SPIE EDUCATIONAL SCHOLARSHIP APPLICATION FORM

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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
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