Society of Women Engineers

Society of Women Engineers Connecticut Section Scholarship Committee PO Box 1053 New Canaan, CT 06840-1053

Jean R. Beers Scholarship Application Academic Year 2017-2018 (SWE FY17)

The Jean R. Beers Scholarship is a cash tuition award for female college students pursuing Baccalaureate degrees in Science, Technology, Engineering or Mathematics enrolled full-time during the school calendar year 2017 - 2018.

All portions of applications must be postmarked or emailed by February 1st, 2017.

In addition, applicants must reside or attend a college/university within the SWE Connecticut Section, which is bounded by the following zip codes. Please CIRCLE the appropriate zip code:

Any Zip code starting with: 065__ 066__ 068__ 069__ (fill in the blanks), Or, one of the below:

Starts with 060: Starts with 064: Starts with 067: 06039 06401 06426 06468 06484 06702 06716 06753 06784 06068 06403 06430 06470 06487 06703 06720 06754 06785 06069 06404 06431 06471 06488 06704 06721 06755 06786 06079 06405 06432 06472 06490 06705 06722 06757 06793 06409 06436 06473 06491 06706 06723 06762 06794 06413 06437 06475 06497 06707 06724 06770 06795 06418 06440 06477 06498 06708 06725 06776 06796 06419 06442 06478 06709 06726 06777 06424 06443 06482 06710 06751 06779 06425 06460 06483 06712 06752 06783

1. Personal Data: Name: Current Address: City: State: Zip Code: Permanent Address: City: State: Zip Code: Home Phone: Cell Phone: School Phone: E-mail address:

***PLEASE DO NOT PLACE ANY PERSONAL DATA INCLUDING YOUR NAME ON FURTHER PAGES EXCEPT THE FINAL PAGE*** 2. Educational / Financial Data: High School Attended: College/University Attending 2016-2017 Academic Year:

Current GPA/GPA Scale: College or University Attending Fall Semester 2017:

Major: Degree Expected: Expected Graduation Date: Credits Credits Required: Completed:

Enrolled In: Currently In: Anticipated Expenses for Next Source of Income for Next 2 year program 1st year Academic Year: Academic Year: 4 year program 2nd year Tuition $ Parents/Family % 5 year program 3rd year Room & Board $ Scholarships % Other 4th year Books & Supplies $ Loans % 5th year Transportation $ Employment % Other Other $ Work/Study % TOTAL $ Other %

3. Transcript: Applicant must submit an official copy of their most recent college transcript for consideration.

4. Applicant’s Statement: A statement or essay written by the applicant, NO MORE THAN ONE (1) SINGLE-SIDED 1.5- SPACED TYPED PAGE, describing one or more: a. Why she chose a major in Science, Technology, Engineering or Mathematics b. How she believes she will make a difference in her chosen profession. c. Explain what influenced her to study in her chosen field.

*PLEASE do NOT put your name in the personal statement page document*

5. Professional Data and Other Relevant Data: Please attach a 1-page resume including a brief description of any work or volunteer experience, and any other pertinent information. Include any AWARDS (Names/Years) and/or other activities, research projects, design projects, design teams, interests, hobbies or other pertinent information.

*PLEASE do NOT put your name, address or other contact information in the resume*

In the first step of our review process, the files names are assigned a number and the personal info pages (1 & 3) are removed from the application file. By doing this, the reviewers are looking only at content and can objectively review the application. That's why we ask you to not include your name in the personal statement or the resume; to make the review preparation process easier. 6. Certification: I hereby certify that all of the above an any supplemental information is true, and that I intend to be enrolled as a full time undergraduate student with a major in Science, Technology, Engineering or Mathematics in September 2017. I further certify that I am not receiving full funding for my education from an employer, any branch of the Armed Services or other organization. By submitting this application I understand that such information is confidential and subject to verification by SWE Connecticut.

______Signature or Typed Signature Date

Please submit your application, preferably via email to [email protected], or mail to: Society of Women Engineers Connecticut Section Scholarship Committee PO Box 1053 New Canaan, CT 06840-1053

For up to date information please visit www.swect.org Any questions please email [email protected]