Innovative Signal Analysis
Fellowship Application Form
SUBMITTAL DEADLINE: October 4, 2013
Student ID #____________
Date:____________
Directions: This application must be filled out completely and accurately. PRINT or
TYPE all information requested. Applications must be accompanied with a student
resume, current transcript, and a letter of recommendation from a faculty member.
Applications and supporting material are to be emailed to tom.helsley@signal-analyis.com
Requirements: This application is for students within the Electrical or Physics Engineering Departments
with a minimum 3.5 GPA, who are in their first to third year of graduate studies, and are U.S. Citizens.
ISA is a U.S. Government defense contractor and scholarship candidates must be able to meet the
requirements to obtain a U.S. Government security clearance.
Name:_______________________________________
(Last)
(First)
Local Phone: _____________
(Middle)
Local Address: __________________________________________________________
(Street or Box)
(City, State, Zip)
Permanent Address: ______________________________________________________
(Street or Box)
(City, State, Zip)
Email Address: _________________________________________________________
Focus of Graduate Studies:_________________________________________________
_______________________________________________________________________
Undergraduate Cumulative GPA: _____
Major Graduate GPA: ______
Graduate GPA: _____
I am currently in my ____ year of graduate study and working toward a _______ degree.
Expected Graduation Date: ____________
U.S. Citizen:
Yes ___
No ___
Do you agree to allow the release of your application/records to scholarship donor?
Yes ___
No ___
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Innovative Signal Analysis
Fellowship Application Form
List any Fellowships, loans, grants, etc. you have received or expect to receive while
attending graduate school.
Name of Source
Amount Per Year
Scholarships
Loans
Grants
Gifts
Other
Academic Distinctions, Awards, and Honors received (undergrad and grad level)
Distinction/Awards/Honors
Date Received: MM/YEAR
Are you currently or have you been in a CO-OP Program? □ No
□ Yes
If yes, how many terms? _________ Which company? ______________________
Have you been involved in a summer Internship Program? □ No
□ Yes
If yes, which company? ____________________________________________________
Work History: List jobs held within the last four years:
Employer
Location
Position
From:
mm/yyyy
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To:
mm/yyyy
Hrs worked
per week
Innovative Signal Analysis
Fellowship Application Form
Describe why you chose your area of graduate studies and the challenges encountered?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
If writing a thesis, summarize your status and research to date.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Describe any unusual circumstances that should be considered when evaluating your application.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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