<p> CHI EPSILON</p><p>THE NATIONAL CIVIL ENGINEERING HONOR SOCIETY</p><p>PURDUE UNIVERSITY CHAPTER Leonard and Margaret Wood Award Application Form Applications are due by Tuesday, October 17th, 2017. Submit all materials as one PDF to Gwen Cortez at [email protected]</p><p>Name of Nominee: ______</p><p>Name of Nominator: ______</p><p>CRITERIA AND GUIDELINES</p><p>1. Completed application form and all required materials are to be submitted as a single PDF, and must be emailed to Gwen Cortez at [email protected] by October 17, 2017.</p><p>2. Any active member of the Purdue Chapter of Chi Epsilon may apply.</p><p>3. Recipients of this scholarship shall be students who are pursuing a degree in civil engineering with an outstanding academic record and a strong commitment to Chi Epsilon as demonstrated by chapter activity and participation, with priority to students participating in the co-op program.</p><p>4. There are three parts to the nomination form. • Part 1, the nomination, to be completed by the nominator • Part 2, the application, to be completed by the nominee • Part 3, the attachment of the nominee's unofficial transcript</p><p>5. Award candidates are to be nominated by an active member of Chi Epsilon. Nomination by another person is preferred to self-nomination.</p><p>6. You can easily acquire a PDF of your transcript by following these instructions. You should receive it via email within 30 minutes. 1. Log into myPurdue. 2. Click on the "Academic" Tab. 3. Click on "Order Official Transcript" Button on the bottom left column. 4. Scroll down to the bottom of the window that comes up, and click "Order Electronic Transcript." 5. Fill out the Recipient Information, and click "Submit."</p><p>Page 1 of 5 CHI EPSILON</p><p>THE NATIONAL CIVIL ENGINEERING HONOR SOCIETY</p><p>PURDUE UNIVERSITY CHAPTER 6. On the delivery timing page, click on "Current”, and click "Submit." 7. Follow directions on next two screens to submit your order.</p><p>Page 2 of 5 CHI EPSILON</p><p>THE NATIONAL CIVIL ENGINEERING HONOR SOCIETY</p><p>PURDUE UNIVERSITY CHAPTER PART 1: Nomination To Be Completed by the Nominator</p><p>Please provide a brief description of why you think this student merits the award:</p><p>SIGNATURE</p><p>______Signature, Nominator Date</p><p>Page 3 of 5 CHI EPSILON</p><p>THE NATIONAL CIVIL ENGINEERING HONOR SOCIETY</p><p>PURDUE UNIVERSITY CHAPTER PART 2: Application To Be Completed by the Nominee</p><p>PERSONAL INFORMATION</p><p>Name:</p><p>Date:</p><p>Campus Mailing Address:</p><p>Telephone:</p><p>Projected Graduation Date: </p><p>Current GPA:</p><p>Credits Completed:</p><p>Membership in Organizations</p><p>Offices You Have Held</p><p>Honors, Awards, Scholarships</p><p>Page 4 of 5 CHI EPSILON</p><p>THE NATIONAL CIVIL ENGINEERING HONOR SOCIETY</p><p>PURDUE UNIVERSITY CHAPTER </p><p>Outside Activities, Hobbies </p><p>Work and/or Research Experience</p><p>Page 5 of 5 CHI EPSILON</p><p>THE NATIONAL CIVIL ENGINEERING HONOR SOCIETY</p><p>PURDUE UNIVERSITY CHAPTER </p><p>ESSAY</p><p>Write a summary stating your professional goals and objectives and any other information that you feel is pertinent to this application. </p><p>SIGNATURE</p><p>Part 3 of this application, my Purdue transcript, has been attached to this application form as part of this single PDF.</p><p>______Signature, Nominee Date Page 6 of 5</p>