FIRST Robotics Scholarship Application, 2012
All application materials must be received by a participating ITT Technical Institute by
April 13, 2012. Please print all information provided below.
Applicant’s Name _______________________________________________________
Home address _________________________________________________________
Home telephone ________________________________________________________
FIRST Team Name _____________________________________________________
FIRST Team Adult Mentor/Coach Name_____________________________________
Adult Mentor/Coach Telephone ___________________________________________
FIRST Region _________________________________________________________
Applicant’s High School __________________________________________________
Anticipated Date of High School Graduation __________________________________
Be sure to attach to this application form your:
□ High school transcript
□ Letter of recommendation from an adult sponsor of your FIRST team describing
your level of participation on and commitment to the FIRST team.
□ Letter written by you describing what you learned about mathematics, science or
technology through participation on the FIRST team as well as what you learned
about team participation.
Your application materials should be addressed to the Dean at the participating ITT
Technical Institute nearest you. For a listing of participating ITT Technical Institutes,
please go to: www.usfirst.org/scholarships-itttech
For information about programs of study offered by ITT Technical Institute, visit
www.itt-tech.edu.