Northern Arizona University College of Engineering, Forestry, & Natural Sciences (CEFNS) TRANSFER-GEMS SCHOLARSHIP APPLICATION FORM For the 2016-2017 Academic Year

This scholarship is only available to new transfer students with an approved CEFNS major* and is supported by the Return completed application packet including questionnaire, National Science Foundation under Grant Number 1260138. unofficial transcript and letter of recommendation to Jen Johnson, *All CEFNS majors except Biomedical Science, Exercise Science, Bldg. 21 room 132 or email to [email protected] by 5 pm on Chemistry-Health Preprofessional and Secondary Education. Monday March 21, 2016 for priority consideration. Questions? Student must have $2,500 minimum financial need as determined Contact: by information provided on 2016 FASFA [email protected] or 928-523-5528

APPLICANT INFORMATION Applicant name (last, first, middle initial): NAU ID # Click here to enter text. Click here to enter text. Date of Birth: Click here to enter text. E-mail Address: Current phone number: Race/Ethnicity (this is for NSF reporting only - mark all that apply): Click here to enter text. Click here to enter text. ☐ American Indian or Alaska Native ☐ Asian ☐ Black or African American ☐ Hispanic or Latino ☐ Native Hawaiian or Other Pacific Islander ☐ White State: Click ZIP Code: Click City: Click here to enter Address: Click here to enter text. here to here to enter text. enter text. text.

ACADEMIC INFORMATION Minor or emphasis (if No. of Credits Transferring to NAU Intended Major: School transferring from: applicable): NAU: Click here to enter Click here to enter text. Click here to enter text. Click here to enter text. text. Current GPA: Click here to enter text. Other institutions attended: Click here to enter text.

You are currently a: ☐ full-time student ☐ part-time student ☐ neither High School Name, City, State: Click here to High School GPA: Click Have you completed college level Have you completed college pre-calculus (MAT 125)? level General Chemistry enter text. here to enter text. (CHM 151/L)?

☐ ☐ ☐ Yes No In-Progress ☐ Yes ☐ No ☐ In-Progress How many credit hours do you plan to enroll in during the academic year? Fall 2015: Click here to enter text. Spring 2016: Click here to enter text.

BACKGROUND INFORMATION

Are you a first generation college student? Are you a U.S. citizen? ☐Yes ☐No If no, list your Country of Citizenship: Click here to enter text. ☐ Yes ☐ No Are you an Arizona resident? Do you plan to work during the academic year? ☐ Yes ☐ No Hours per week? Click

☐ Yes ☐ No here to enter text.

1 Northern Arizona University College of Engineering, Forestry, & Natural Sciences (CEFNS) TRANSFER-GEMS SCHOLARSHIP APPLICATION FORM For the 2016-2017 Academic Year Have you completed a Federal Student Aid application (FAFSA) for 2016-2017 academic year? Note: this is required to be eligible for this scholarship. Do you plan to complete your degree at NAU? ☐ Yes ☐ N0 ☐ Unsure ☐ Yes ☐ No

ACADEMIC/PROFESSIONAL INTEREST Please mark all Science, Technology, Engineering and Math (STEM) areas of interest. These interests must be included in your essay.

Civil Engineering ☐ Biological Sciences ☐ Environmental Engineering ☐ Chemistry and Biochemistry ☐ Electrical Engineering ☐ Physics and Astronomy ☐ Mechanical Engineering ☐ Mathematics and Statistics ☐ Computer Science ☐ Environmental Science ☐ Construction Management ☐ Geology ☐ Forestry ☐ Other: Click here to enter text.

Do you plan to live on campus? ☐ Yes ☐ No If yes, are you interested in participating in the Transfer-GEMS Residential Learning Community*? ☐ Yes ☐ No Are you interested in participating in Transfer-GEMS academic and social events and activities? ☐ Yes ☐ No

*Living on campus in an upper-classman, suite-style residence hall with other Transfer-GEMS students ______

Along with this application, please submit the following documents: 1.) Unofficial transcripts from all institutions from which you are transferring credit. (Note: Official transcripts will be required at a later date) 2.) Completed questionnaire/essay (pages 3-4 of this application). 3.) One letter of recommendation from a faculty member or employer who is familiar with your work.

Only complete application packets will be considered for this scholarship. The application deadline for priority consideration is 5 pm March 21, 2016.

By submitting this Scholarship Application Packet, you are giving your consent for NAU to release your personal information to individuals who will be considering you for this scholarship. This includes, but is not limited to, your application information, GPA, financial need, transcripts, etc. Also, should you be selected to receive this scholarship, updates of your progress at NAU including GPA, classes taken, financial need, etc. will be required. Submission of this application confirms that you agree to these terms and conditions.

If selected for this scholarship, you also agree to:

- be enrolled as a full time student (12 units minimum) each semester of award. - participate in required Transfer-GEMS mentoring program and related activities each semester of award. - meet 3.0 minimum GPA requirement each semester of award. Failure to meet this requirement will result in the discontinuation of scholarship award. - complete all surveys and questionnaires required for program evaluation purposes each semester of award. - participate in the College of Engineering, Forestry & Natural Sciences Awards Ceremony (if scheduled).

I have read and agree to the above terms and conditions.

Click here to enter text. Click here to enter text.

2 Northern Arizona University College of Engineering, Forestry, & Natural Sciences (CEFNS) TRANSFER-GEMS SCHOLARSHIP APPLICATION FORM For the 2016-2017 Academic Year Student Signature Date Print Name

3 Northern Arizona University College of Engineering, Forestry, & Natural Sciences (CEFNS) TRANSFER-GEMS SCHOLARSHIP APPLICATION FORM For the 2016-2017 Academic Year TRANSFER-GEMS APPLICANT QUESTIONNAIRE

Applicant Name: Click here to enter text. NAU ID: Click here to enter text.

Applicant Signature: ______Date: Click here to enter text.

As a required component of your Transfer-GEMS application, please answer the following questions about your involvement and interests in science, technology, engineering and/or math (STEM).

1. Please rate how easy it is for you to do the following tasks on a scale from 1 to 5, where 1 is not at all easy and 5 is very easy.

a.) Draw a graph depicting the relationship between two variables Rating: Click here to enter text. (for example, temperature and pressure). b.) Interpret a graph depicting the effect of more than one Rating: Click here to enter text. Independent variable on an outcome (for example, the effect of both temperature and rainfall on plant growth). c.) Design an experiment to test the effect of temperature on a Rating: Click here to enter text. chemical or biological process such as decomposition of leaves. d.) Design and build a tool or structure. Rating: Click here to enter text.

e.) Identify science questions in a news article. Rating: Click here to enter text.

2. Please describe how your prior experiences (in school or in your extra-curricular life) have influenced the ratings you just provided. If your ratings are different for different tasks, please explain why you feel more confident about one task than another.

Click here to enter text.

4 Northern Arizona University College of Engineering, Forestry, & Natural Sciences (CEFNS) TRANSFER-GEMS SCHOLARSHIP APPLICATION FORM For the 2016-2017 Academic Year 3. How much time (on average) do you spend each week in the following activities? Please estimate to the nearest hour (for example, 5 hours per week).

a) Attending science and math classes. Click here to enter text.

b) Completing science and math homework on your own. Click here to enter text.

c) Completing science and math homework with others. Click here to enter text.

d) Working on STEM projects in a club or as a hobby. Click here to enter text.

e) Working on STEM projects in a volunteer or paid work setting. Click here to enter text.

4. Besides school, in what ways have you engaged in science, math, or engineering-related activities (for example, clubs, hobbies, projects, reading, work)?

Click here to enter text.

5 Northern Arizona University College of Engineering, Forestry, & Natural Sciences (CEFNS) TRANSFER-GEMS SCHOLARSHIP APPLICATION FORM For the 2016-2017 Academic Year

5.) Please attach a double spaced essay (up to two pages maximum) describing your interest in pursuing a Bachelor of Science (or higher) degree in a STEM major and your future career goals. Please include your academic and professional interests, leadership qualities, work ethic and views on the value, roles and responsibilities of your intended profession.

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