American Indian Science and Engineering Society
Cal Poly State University, San Luis Obispo
Scholarship Application
2008-2009 Chevron Scholarship Application must be postmarked by September 5, 2008
Award
§ One $1,000 in-state scholarships (possibly renewable) -or-
§ One $1500 out of state scholarships (only out of state applicants may apply)
Eligibility
§ Must be a graduating High School Senior or College Transfer student
§ Must be a full time student attending Cal Poly, SLO (starting Fall 2008)
§ Must be pursuing a Bachelor of Science Degree in science, math or engineering
§ Must show proof of American Indian descent by one of the following:
Tribal affiliation number (documentation copy) or Tribal enrollment card
Birth certificate (copy)
Family tree showing descent
Or demonstrated interest and involvement in Native American issues.
§ Must become or already be a paid national member of AISES, annual dues are $25 per year and can be obtained at http://aises.org
§ Must continue to be an active member of the club upon receiving the award (i.e. attend meetings regularly as well as participate in special events)
Selection Criteria
§ Points will be awarded for the following weighted categories:
Financial need
GPA
Motivation and anticipated involvement in AISES
Letter of Recommendation
Essay, relating interest, involvement to Indian Heritage, and motivation/intention to participate in AISES
Awarded students will be recognized at the first meeting of the year on Tuesday September 25, 2007 at 11:00am in the University Union (bldg. 65) room 218.
General Information
Name (please print): / Social Security #:Phone Number: ( ) / Email:
Mailing Address: / Tribe:
According to our records, you are listed as American Indian.
Is this true? YES___ NO___
According to our records, you are listed under an Engineering, Math, or Science Discipline.
Is this true? YES___ NO___
Financial Information
Because this scholarship will be awarded with consideration to financial need, it is necessary for us to request information about your current financial situation.
Number of siblings: ______How many are in college, including yourself: ______
Parent’s current marital status: Married____ Single____ Widowed___ Divorced/Separated___
Each applicant’s family income will be taken into consideration for scholarship selection. Please fill in the portion below pertaining to employment and other forms of income. This information will be held in the strictest confidence within AISES.
Family/Student Annual Income:
___Below - $20,000 ___$20,001-$30,000 ___$30,001-$40,000 ___$40,001-$50,000 ___$50,001-Above
Estimated support for 2007-2008 school year :______( Please include additional scholarships and financial assistance)
List Sources:
Certification: All information on this application is true and complete to the best of my knowledge. I hereby give AISES permission to review information in this application for the purpose of selection, recruitment, and public relations. If selected, I will become a participating member in AISES and will use the AISES Chevron Scholarship toward education related expenses. I further certify that I will be enrolled at Cal Poly, San Luis Obispo, as a full time student this academic year.
______
Signature Date
Check-off List
Please check off the following items as you complete the application form:
¨ I have read and met the eligibility requirements
¨ I have enclosed proof of my American Indian descent
¨ I have enclosed an essay relating my interest in my Indian Heritage and/or motivation/intention to participate in AISES
¨ I have enclosed one letter of recommendation
¨ I have signed and dated the scholarship application form
If you have any questions regarding the scholarship or AISES, please contact any of the following individuals:
AISES/CHEVRON SCHOLARSHIP 08-09 3 of 3
David Cantu Thomas Miller Ember Jensen
MEP Director AISES President AISES VP
(805)756-1433
AISES/CHEVRON SCHOLARSHIP 08-09 3 of 3