The Central Pennsylvania Section of ASCE is pleased to announce the establishment of a Student Award program for the current calendar year. Interested students should complete and submit this application form by October 16, 2015.
Return completed applications to: Christopher Smith cwsmith@modjeski.com
Or by mail: Christopher Smith
ASCE, Student Awards Committee c/o Modjeski and Masters, Inc.
100 Sterling Parkway, Suite 302
Mechanicsburg, PA 17050

Up to four (4) awards in the amount of $2,000.00 each will be awarded in November 2015.

1.
Be a member of an ASCE Student Chapter with a current member number provided by ASCE
National.
2.
The applicant must finish at least the sophomore year by August 1, 2015. Applicant is eligible to
3.
receive the award once, either in their junior year or in their senior year.
The applicant must be enrolled in a Civil Engineering (CE), Civil Engineering Technology (CET),
4.
Architectural Engineering (AE), Architectural Engineering Technology (AET), Environmental
Engineering (EE), Surveying Technology (ST) or Construction Management Engineering Technology
(CMET), or other approved Civil Engineering program curriculum
The applicant must be either enrolled at Bucknell University, Messiah College, Pennsylvania College of Technology, Pennsylvania State University, Pennsylvania State University-Harrisburg or have permanent residence within the boundaries of the Central Pennsylvania Section and attend another college or university. (Note: The Central Pennsylvania Section includes Adams, Centre, Clinton,
Cumberland, Dauphin, Franklin, Juniata, Lancaster, Lebanon, Lycoming, Mifflin, Montour,
Northumberland, Perry, Potter, Snyder, Tioga, Union and York Counties.)
5.
Not have previously been awarded the Central Pennsylvania Section ASCE Student Award.

Each applicant will be evaluated using the rating system described below:
1. Grade Point Average and Class Rank 30 points maximum
Students will be rated based upon their cumulative grade point average and class rank.
2. Honors and Activities 30 points maximum
Students will be rated based upon a subjective evaluation of activities, such as ASCE, honors, and employment history. While honors associated with grade point average considered above should be included, particular emphasis in this category will be given to honors and activities separate and distinct for those associated with grade point average.
3. Advisor Recommendation 20 points maximum
Students will be rated based upon written recommendations from their advisor, including student’s character, professionalism, academic standing, other factors and, if known, financial status.

4. Student essay 20 points maximum
Student’s essay (not to exceed 200 words) will be rated based on content and presentation including grammar and spelling. Essay can be about career goals, role of civil engineers in society, how the student believes they will make a difference to society, or any related topic of the student’s choice.

Fill in all applicable blanks as indicated below. Type or print clearly. Include one copy of
Transcript of Grades as well as the student essay with this completed form. The Civil Engineering, etc. Department
Head must certify the applicant’s student status and eligibility for the award. Provide a copy of the completed application and Recommendation Form to your advisor. Have your advisor return the Recommendation Form directly to the ASCE Central Pennsylvania Section.
Name________________________________________________________________________________
(Last) (First) (Middle)
Permanent Mailing Address_______________________________________________________________
(Number and Street) (City) (County) (State) (Zip)
Local Address _________________________________________________________________________
(if different from above) (Number and Street) (City) (County)
Telephone Number_______________________ Date of Birth_______________
(State) (Zip)
(Include area code)
Email Address
(Month / Day / Year)
College or University ___________________________________________________________________
(Name)
Student Status
___________________________________________________________________
(City) (State)
Junior Senior
(Circle or Highlight One)
____________________________
(Semester or Term)
Curriculum CE CET AE AET EE ST
(Circle or Highlight One)
CMET Other__________________
Cumulative Grade Point Average_________________________
Attach Transcript of Grades
Work Experience: List part-time and summer jobs you have held since your senior year in high school
(please continue on a separate sheet if required).
Employer
Duties
Employer
Duties
Dates of Employment
Dates of Employment
Hours Per Week
Hours Per Week
What percent of your tuition (including room and board) is financed by your part-time or summer employment? _______________

Activities: List your school / community activities (other than jobs), in the order of interest to you, in which you have been involved since your senior year in high school (please continue on a separate sheet if needed). Expand on any leadership roles undertaken with each activity.
Activity
Your most significant contribution
Activity
Your most significant contribution
Activity
Your most significant contribution
Activity
Your most significant contribution
Activity
Your most significant contribution
Activity
Your most significant contribution
Hours Per Week
Hours Per Week
Hours Per Week
Hours Per Week
Hours Per Week
Hours Per Week
School Year (s)
School Year(s)
School Year(s)
School Year(s)
School Year(s)
School Year(s)
Honors: List any special honors and awards you have received, either in or out of school, since your senior year in high school.
Description of Honor or Award (please continue on a separate sheet if needed). School Year Awarded
Prepare an essay (not to exceed 200 words), describing your career goals, role of civil engineers in society, how the student believes they will make a difference to society, or any related topic of the student’s choice.
Include essay with application

I hereby certify that the academic information as submitted in this application is correct and that the applicant meets the eligibility requirements outlined herein.
Signature____________________________________________ Date____________________________
Printed Name_________________________________________ Title____________________________
College or University____________________________________________________________________
Address______________________________________________________________________________
(Department) (Number and Street)
_______________________________________________________________________________
(City) (State) (Zip)
Telephone Number_____________________________________________________________________
Provide the “Advisor Recommendation Form” to your college advisor for completion. The
Recommendation Form is to be returned directly to ASCE Central Pennsylvania Section by your advisor.
This form must also be returned by the application deadline of October 16, 2015.
This space for Award Committee use

Part I of this form is to be completed by the student applicant. Provide the form to your college advisor for completion of Part II.
Applicant’s Name_______________________________________________________________________
(Last) (First) (Middle)
Permanent Mailing Address_______________________________________________________________
(Number and Street) (City) (County) (State) (Zip)
(if different from above)
Local Address _________________________________________________________________________
(Number and Street)
(Include area code)
(City) (County) (State) (Zip)
Telephone Number___________________________ Local Telephone Number______________________
(Include area code)
The student listed above is applying for an award sponsored by the ASCE Central Pennsylvania Section.
As a part of the evaluation of the student’s academic qualifications, the applicant’s college advisor is requested to complete Part II herein and send the entire form directly to the ASCE Central Pennsylvania
Section. The advisor’s comments are an important consideration in the award competition. Use additional sheets to complete this form, if needed.
All information contained on this form will be considered confidential by the ASCE Central Pennsylvania
Section.
Advisor’s Name________________________________________________________________________
(Last) (First) (Middle)
College or University____________________________________________________________________
Address______________________________________________________________________________
(Department)
_______________________________________________________________________________
(Number and Street) (City) (State) (Zip)
Telephone Number_________________________ Position_____________________________________
(Include area code)
1.
How long have you known the applicant? From _____________ to ______________
2.
Is the applicant enrolled in a Civil Engineering ___ Civil Engineering Technology ___ Architectural
Engineering ____ Architectural Engineering Technology ____ Environmental Engineering ____

Surveying Technology ____ Construction Management Engineering Technology ____ or Other
_________________ curriculum? (Please select one)
3.
Will the applicant be considered a junior or senior after August 1 of this year? __________________
4.
What is the applicant’s class standing? Top 5% ____ Top 10% ____ Top 20% ____ Top 30% ____
Top 50% ____ Other _________ (Please select the most appropriate)
5.
Do the applicant’s activities include membership in any professional societies? (Please list) _________
____________________________________________________________________________________
6.
Has the applicant held office in any professional societies? (Please list) _________________________________
_____________________________________________________________________________________________
7.
Are you aware of the applicant’s involvement in extracurricular activities? Y / N If yes, please comment.
_____________________________________________________________________________________________
_____________________________________________________________________________________________
8.
Do you know of anything reflecting adversely on the integrity and general good character of the applicant? Y / N
If yes, please comment _______________________________________________________________________
9.
Please comment on the applicant’s character and reputation __________________________________________
_____________________________________________________________________________________________
_________________________________________________________________________________________
10.
In what regard is the applicant held by his/her instructors?___________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
11.
In what regard is the applicant held by his/her fellow students?________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
12.
Are you aware of any special financial difficulties being experienced by the applicant, which should be considered by the award committee? Y / N If yes, please comment ____________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
Advisor’s Signature________________________________
Date________________________________
The completed Advisor Recommendation Form should be emailed to Chris Smith at cwsmith@modjeski.com
or mailed directly to the ASCE Student Award Committee at the following address:
ASCE, Student Awards Committee c/o Modjeski and Masters, Inc.
100 Sterling Parkway, Suite 302
Mechanicsburg, PA 17050