For Possible Scholarships and Internships

2007 UMBC CISA Application

for Possible Scholarships and Internships

in Information Assurance

Department of Defense Information Assurance Scholarship Program

and Student Career Experience Program Opportunity

Name:______

first m.i.lastnickname

Are you a USA citizen?:yesno

Are you at least 18 years old?yes no

SSN: ______

degree program at UMBC:BA/BSMA/MSPhD

UMBC major: CMSC EE CE IFS Other: ______

Are you interested in a possible internship without scholarship support?yesno

Check List

completemissing

ℊℊDoD Scholarship Vacancy Announcement Form

ℊℊAll college transcripts

ℊℊSAT or GRE scores

ℊℊBrief personal statement (about one page) describing your experience,

motivation, and plans.

ℊℊResume

Three letters of reference, including one from a regular UMBC faculty

member, or the names of people who promise to write such letters:

ℊℊ1. ______

ℊℊ2. ______

ℊℊ3. ______

Deadlines

Scholarship applications must be received by 4pm, February 15th, in:

ITE 325:

Attn: Jane Gethman

telephone: 410-455-2713, fax: 410-455-1048

email:

For More Information Contact

Dr. Alan T. Sherman, Director, UMBC Center for Information Security and Assurance (CISA),

, telephone 410-455-2666, fax 410-455-3969

Name:______

Contact Information (spring)

mailing address:______

______

email:______

phone:______

Contact Information (summer)

mailing address:______

______

email:______

phone:______

Additional notes on how to contact you (optional)

Name:______

Academic Information

year at UMBC:U1U2U3U4G1G2G3G4G5

credit hours completed:at UMBC______total______

GPA at UMBC:______(on 4-point scale)

Standardized Test Scores

SATmath______verbal______total______

GREmath______verbal______analytical______total______

List All Colleges and Universities Attended

Name of SchoolLocationDegreeMajorDatesDegree GPA

SoughtAwarded?

______yes no______

Name: ______

List all information assurance courses taken

Course nameCourse NumberInstructorSchoolSemesterGrade

1.______

2.______

3.______

4.______

5.______

6.______

7.______

8.______

9.______

10.______

CISA Application1 of 5UMBC