CSEM Scholarship Application Form Funded by NSF The Community College of Baltimore County Computer Science, Engineering and Mathematics Scholarships (CSEMS) For 2007-2008 Academic Year (Type or print clearly and mail as per below) Name __________________________________________________________ Date of Birth: ______________________________________ SS#:  _________________________________ Gender: ___ Female ___Male Street Address:  ___________________________________________ Apt. #:  ______ City _________________________________ State ____________________ Zip ______ Telephone (D) _______________ (E) _______________ Email ______________________________ The following information is needed for reporting to the National Science Foundation:  Ethnicity: ___ Hispanic or Latino ___ Not Hispanic or Latino Race: ___ American Indian or Alaska Native ___ Asian ___ White ___ Black or African American ___ Native Hawaiian or Other Pacific Islander ___ Disability Status: Hearing ___ Vision ___ Mobility ___ Learning ___ Other Are you currently employed. If so, how many hours per week? _______________________ CSEM Scholarships are for students in the following six Associate's degree programs. Check your field of study: ___ Computer Information Systems/Networking (CINS/DCOM) ___ Computer Science (CMSC) ___ E-Business (EBUS) ___ Engineering (ENGR) ___ Internet and Multimedia Technology/Simulation and Digital Entertainment (IMMT/SDE) ___ Mathematics (MATH) CSEM Scholarship applicants must be in one of the following five categories, A  E. Circle the category that best describes you:  Circle Category Type of Applicant A Current High School Senior B Recent High School graduate (within 3 years after high school graduation) C Current CCBC student D Student with other higher education E Other - Student with disabilities - Single Parent/Displaced Homemaker - First-in-Family college student - Returning adult   CSEM Scholarships must meet one of the following citizenship/residency requirements; Check the one that describes you: ___ United States Citizen ___ Permanent Resident Alien ___ Refugee Alien   Requirements for all CSEM Scholarship applicants:  1. Must complete this application form. Due in Office by June 10 for Fall semester, and by December 10 for Spring semester. Mail to: Mrs. Darnell, CSEMS Application, CCBC Essex, Room F410, 7201 Rossville Blvd. Baltimore, MD 21237 2. Must write and attach an essay on why applicant should receive a CSEM Scholarship and also what your career goal is; 2 pages maximum, typed and double-spaced. 3. Complete the Free Application for Federal Student Aid [FAFSA] and obtain signature from CCBC Financial Aid Officer in space at bottom of this page. 4. Must be accepted for admission to CCBC. 5. Attach CCBC transcript from the Records and Registration Office (and letter of recommendation if you are a Category E applicant as described in the chart below.)   Category Type of Applicant Criteria for Consideration Application Deadline Additional Requirements A Current High School Senior Grade Point Average (GPA) 2.5 at mid-year, senior year Must have completed Algebra I with C or higher. For best consideration apply by: June 10 for the upcoming Fall semester December 10 for the upcoming Spring semester Current High School transcript. B Recent High School graduate (within 3 years after high school graduation) Grade Point average 2.5 at graduation Must have CCBC Math Placement test level of MATH 082 or higher. High School transcript C Current CCBC student 12 credits earned within last 3 years; 2.5 GPA Must have completed MATH 081 or higher, or have CCBC Math Placement test level of MATH 082 or higher. Current CCBC transcript D Student with other higher education 12 credits within last 3 years; 2.5 GPA Must have completed MATH 081 or higher, or have CCBC Math Placement test level of MATH 082 or higher. All applicable transcript(s) E Other Student with disabilities Single Parent/Displaced Homemaker First-in-Family college student Returning Adult Applicant must obtain a letter of recommendation from CCBC student support services counselor Must have completed MATH 081 or higher, or have CCBC Math Placement test level of MATH 082 or higher. Specific recommendation from CCBC student support services Current CCBC transcript if any courses have been taken. I understand that as part of the scholarship terms, there are 3 days of required career-related experiences held during the summer in the week before classes begin, and a series of 2 seminars during each semester for awardees. I will receive further information about these if I am selected. I also understand that a personal interview at CCBC may be required before the scholarship is awarded. Signature of Applicant:  ______________________________________________________ Financial Aid Eligibility: Go to the Office of Financial Aid, A140 Verification of unmet Financial need at CCBC for academic year 2007-2008 Unmet Financial Need:  ___ Yes ___ No Amount:  __________________ Signature:  ________________________________________ Date _____________                             Ms. Beverly Eurice, Financial Aid A140 Essex Campus 443-840-1302