/ UNT Science and Mathematics

Robert Noyce Scholarships

Applicant Form

Personal Information

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Last Name / First Name / Middle initial
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School Address / Permanent Address (if different)
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City / City
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State Zip Code / State Zip Code
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Primary Phone (check one):  Home  Cell / Secondary Phone (check one):  Home  Cell
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Primary email / Alternate email
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UNT Student ID / Gender
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Social Security Number / Country of Birth
______/ Ethnicity (check one)
Date of Birth
Citizenship (check one)
 US Citizen
 US National
 US Permanent Resident Alien /  African American
 Asian
 Caucasian /  Hispanic
 Native American
 Other (specify) ______

Academic Information

Current Class Level (check one) / Target certification field (check one)
 Junior
 Senior
 Graduate (certification only)
 Master’s degree seeking /  8-12 Science
 8-12 Chemistry
 8-12 Life Science /  8-12 Mathematics
 8-12 Physical Science
 8-12 Mathematics/ Physic
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Expected Degree (indicate date expected) / Earned Degree (indicate date awarded)

Essay

Describe your teaching philosophy using 400-600 words and note experiences related to teaching practice.


Applicant Certification and Release of Information

Please read and initial that you understand and agree to each of the following statements.

______/ I certify that all of the information on this application is true and complete to the best of my knowledge.
______/ I certify that I meet and will maintain all of the eligibility requirements (including maintaining a 3.0 or higher cumulative GPA and full time student status continuously at UNT for the term of my scholarship/ stipend).
______/ If I am an undergraduate, I understand that I must complete a major in a science or mathematics field and complete teacher certification requirements for that field.
______/ I will apply to UNT’s Teacher Education Program via the Teach North Texas Program Advisor if I have not yet been admitted.
______/ I am able to pass all criminal background checks which are conditions for employment in Texas public schools.
______/ I understand that I am obligated to teach full time as a certified teacher in mathematics or science in a high-need Texas public school district for two years for every year of scholarship or stipend support received and that this commitment must be completed within 4 years of graduation if I am an undergraduate and within two years of graduation if I am a graduate. If I fail to complete the teaching obligation as specified, I must immediately repay the total balance of all scholarships/ stipends received.
______/ I authorize exchange and/or disclosure of information among UNT, school districts, the State Board for Educator Certification, the Texas Education Agency, and other entities related to teaching or working with children who are participating in or cooperating in teacher certification programs. Examples of shared information include, but are not limited to: application information, internship eligibility, admission status, academic standing, continued program eligibility, and employment status before and after acceptance in any of the fore-mentioned capacities.
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______/ I understand that the information needs required by the National Science Foundation may change from time to time and I may be contacted for additional information.
I understand that receipt of the NOYCE Scholarship may affect any current Financial Aid packaging I am slated to receive. I also understand that I have the option of requesting, by the time of my interview, a NOYCE award less than the full amount in order to maintain my current sources of financial support. I also understand it is my responsibility to consult the UNT Financial Aid Office to determine if receipt of a lesser award is beneficial.
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Applicant Signature / Date
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Applicant Name (printed or typed)