Eastfield College Texas Science, Technology, Engineering, and Mathematics (T-STEM) Challenge Scholarship Program 2014-2015 Application Packet Purpose The Texas Science, Technology, Engineering or Math (STEM) scholarship at Eastfield College provides funding for high-achieving, eligible students pursuing degree programs in the STEM field disciplines of Computer Sciences, Engineering, Biological Sciences, Mathematics and Statistics and Physical Science. Benefits Students selected as T-STEM Scholars will receive an opportunity to intern, explore careers and network with other STEM students, faculty and industry professionals. The scholarship award amount is $1,250 per semester (Fall, Spring & Summer.) Eligible students must be in good standing with the institution and fulfill all the obligations required by the T-STEM scholarship program. Requirements T-STEM Challenge Scholarships are merit scholarships, based on past and continuing student performance in specific instructional programs. Eligible students receiving a first-time T-STEM scholarship must: - Have graduated from high school with a least a 3.0 GPA on a four-point scale in mathematics and sciences courses; (Recent graduates are encouraged to apply) - Be enrolled in a self-declared program of study in a STEM major field (see attached list) - Agree to work no more than 1-15 hours a week in part time employment to focus on education and career exploration in the STEM field, such as STEM workshops, volunteer/ intern placements or student clubs. - Have a statement on file with the applicant institution indicating that the student is registered with the Selective Service System as required by federal law or is exempted from Selective Service registration under federal law; http://www.sss.gov/default.htm - Plan to complete a minimum of 30 semester credit hours within a year (fall, spring, and summer semesters or equivalent). Student must register for minimum of 12 credit hours each semester with a minimum of 6 credit hours in the summer. Application Process 1. Complete the T-STEM Application, the T-STEM Application Questionnaire, and the T-STEM Scholar Profile and Commitment Agreement. 2. Mail or deliver your completed application packet to: Laura Thomason, Eastfield College Texas-STEM Challenge Program 3737 Motley Dr. C-120 Mesquite, Texas 75150 laurathomason@dcccd.edu 972-860-7379 Application are accepted through August 14th Decisions of the selection committee are final. Supported by the Texas Higher Education Coordinating Board’s Texas-Science, Technology, Engineering and Mathematics (T-STEM) Challenge Scholarship Program Eastfield College Texas Science, Technology, Engineering, and Mathematics (T-STEM) Challenge Scholarship Program T-STEM ELIGIBLE INSTRUCTIONAL PROGRAMS T-STEM Instructional Programs are a defined set of courses that lead to the award of either a certificate or an associate degree in the following U.S. Department of Education Classification of Instructional Programs. Computer and Information Sciences and Support Services Engineering Engineering Technologies/Technicians); Biological Sciences Mathematics and Statistics Physical Sciences o Multi/Interdisciplinary Studies, Biological and Physical Sciences o Health Services/Allied Health/Health Sciences, General o Dental Support Services and Allied Professions o Allied Health and Medical Assisting Services o Allied Health Diagnostic, Intervention, and Treatment Professions o Clinical/Medical Laboratory Science/Research and Allied Health Professions o Health/Medical Preparatory Programs o Ophthalmic and Optometric Support Services and Allied Professions o Rehabilitation and Therapeutic Professions T-STEM OCCUPATION FIELDS T-STEM Occupation Fields serve as a guide for part-time employment for active T-STEM scholarship recipients and for continued eligibility of an awarded applicant based on the employment of graduates. T-STEM Occupation Fields are a set of employment specialties as defined by the Bureau of Labor Statistics as Standard Occupational Classification (SOC) Titles and include: Computer and Mathematical Occupations Engineers Engineering Technicians Life Scientists Physical Scientists Life and Physical Science Technicians Healthcare Practitioners and Technical Occupations Healthcare Support Occupations Eastfield College Texas Science, Technology, Engineering, and Mathematics (T-STEM) Challenge Scholarship Program APPLICATION FORM Application Instructions 1. 2. Please type or use ink and print clearly. Turn in completed application packet, with all applicable signatures to the EFC T-STEM Office. If any part of the application is incomplete, inaccurate, or not signed, your application will not be considered. Applicant Information Applicant First and Last Name: ____________________________________________________________________ DCCCD Student ID#: ____________________ Date of Birth: ______________________ Home Address: ____________________________City:____________State: TX Zip:_______________________ Primary Phone:__________________________ Secondary Phone:_______________________________________ Primary Email Address*:___________________________________________________________________________________ *The “Primary Email Address” you provide here will be used as a central source of communications with Eastfield College. You agree to check your primary email to review any messages from the Eastfield College T- STEM Challenge Program. You also agree to notify the Eastfield College T- STEM Challenge Program immediately of any changes in your “Primary Email Address”. Academic Information Current Academic Classification: □ Freshman □ Sophomore High School Attended____________________________________ High School GPA on a four point scale in mathematics and sciences courses taken: Declared Program of Study at Eastfield____________________________________________________________ College Credit Hours Earned to Date: ___________________________ College Cumulative GPA: ____________ I plan to graduate with an Associate’s Degree from DCCCD Expected Graduation Date _________________ Transfer School & Major___________________ Have you registered with the Selective Services System? Do you intend to take a minimum of 30 semester credit hours within a year (fall, spring, and summer semesters or equivalent) Can you commit to registering for minimum of 12 credit hours each semester with a minimum of 6 credit hours in the summer? Authorization Information _______ (Initial) _______ (Initial) I release to the Dallas County Community College District (DCCCD) and the Eastfield College T- STEM Challenge Program the right to access all my current and ongoing personal and academic records and transcripts. If awarded a student support award, I understand that I must meet the award criteria and Standards of Academic Progress for the DCCCD and the Eastfield College T- STEM Challenge Program. ___I understand my name and information from my academic history may be released to the student support award selection committee(s) and the student support award donor(s). If awarded a student support award, I release to the DCCCD and the Eastfield College T- STEM Challenge Program, the right to arrange a meeting with the donor(s) and use my name, story, and picture for printed and video materials, reports, and press releases, without compensation, as well as I will attend ceremonies and receptions. I certify that the statements herein are true to the best of my knowledge and grant my permission for the information contained herein to be shared with the student support award selection committee(s) and student support award donor(s) Student Signature:________________________________________ Date: ____________________ Eastfield College Texas Science, Technology, Engineering, and Mathematics (T-STEM) Challenge Scholarship Program APPLICATION QUESTIONNAIRE Please limit each of your answers to 250 words. 1. What are your career goals? 2. Describe the reasons for your interest in STEM. 3. What do you hope to accomplish as a professional in a STEM field? 4. What would be most valuable to you as a STEM Scholar and why? Eastfield College Texas Science, Technology, Engineering, and Mathematics (T-STEM) Challenge Scholarship Program PROFILE AND COMMITMENT AGREEMENT T-STEM SCHOLAR PROFILE INFORMATION (Please type or print clearly.) Name: Student ID#: Primary Phone: Primary Email Address: Secondary Phone: Declared STEM Field or Primary Area of Study: Will you be employed during the 2014-2015 academic year? If yes: -time -time Are you receiving financial aid or any additional awards during the 2014-2015 academic year? If so, please list here (examples: Pell, Muse Scholarship, etc. STEM SCHOLAR COMMITMENT AGREEMENT Please review the requirements of the STEM Institute listed below. Then initial next to each item as an acknowledgment of your commitment to satisfy each requirement. Failure to meet these requirements will result in a reduction or loss of the award. ___I will maintain a program of study with DCCCD in an approved STEM field. ___I have a 3.0 GPA or higher and I agree to maintain a cumulative 3.0 GPA or higher through the academic year. ___ I agree to complete a minimum of 30 semester credit hours within a year (fall, spring, and summer semesters or equivalent) ___ I agree to work no more than 1-15 hours a week in part time employment to focus on education and career exploration in the STEM field, such as STEM workshops, volunteer/ intern placements or student clubs. ___ I will respond to contacts regarding student tracking and reporting. ___I understand that failure to meet these requirements will result in a reduction or loss of my award. Student Signature:_________________________________________ Date:____________________