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.