Application for Noyce Scholarships

Instructions: This is the Online Application Form. You may fill it out online using your web browser. When you are finished, simply click on the "Submit this Application" button (at the bottom of the page) and it will be sent automatically to Dr. Wavering. More specific instructions on how to fill out a web based form are available here. If you would like to mail or fax in your application instead, please print out this other form (click here), and follow the instructions that come with it.

Personal Information

Name Email Address Repeat Email Address Local Phone (xxx)xxx-xxxx Cell Phone (xxx)xxx-xxxx

Local Mailing Address

Street City State Zip Code

Permanent Mailing Address

Street City State Zip Code

Undergraduate Information

Undergraduate Institution Major Minor University Semester Hours Completed Grade Point Average (A = 4 pts.) (must exceed 2.7) Last 60 hours Grade Point Average (must exceed 3.0) Expected Graduation Date

Diversity Information

Diversity is important to us, although all candidates will be considered. Please share the following information with us.

Gender

Male Female

Ethnic Origin

References

Your MAT application requires three letters of recommendation. Make sure those letters specifically address your potential as a Noyce Fellow. Please provide the names of your references here.

Reference 1 Reference 2 Reference 3

Statement

In the space below, please provide a brief statement of why you believe you can be successful engaging underrepresented communities in mathematics, science, or engineering.

I have read and understand the Robert Noyce Scholarship Program Student Agreement