Louis Stokes Alliance for Minority Participation Program

Louis Stokes Alliance for Minority Participation Program

Scholars Application

Thank you for your interest in becoming a part of the Kennesaw State University LSAMP Scholars Program, an NSF sponsored program. We are dedicated to increasing the number of underrepresented minority students completing degrees in STEM fields. The LSAMP program is designed to provided recruitment and retention activities for qualified KSU STEM students. Active participants will receive a stipend to support their efforts. To find out more about the program, see the LSAMP Directors or come by the LSAMP Office for more information.

To apply for LSAMP, please complete the attached application and include your current resume, current semester course schedule, and a copy of your KSU transcripts. Please submit the completed application material to Dr. PN Achar (), LSAMP Office at Science Building Room #325.

If you have any questions, please contact:

LSAMP Director

Dr. Premila N. Achar

LSAMP Scholars Application /

We appreciate your interest in Kennesaw State University’s Peach State LSAMP. The ultimate goal of the NSF sponsored LSAMP Program is to increase underrepresented minority students participation in STEM careers, especially by engaging in research experiences. This program is progressive in nature where as the early undergraduates will likely be involved in research shadowing or as lab assistants. Upper class undergraduates will be expected to involved in research laboratory conducting research projects under the direction of an LSAMP mentor. Other opportunities are available for LSAMP scholars as recruitment and retention activity in the areas of academic enrichment and community outreach. Students will be expected to participate in LSAMP specific activities such as general body meetings, LSAMP workshops and the annual LSAMP Peach State Meeting. Failure to meet the expectations of the program will result in a reduced stipend. A completed application does not guarantee acceptance into the program.

Best Wishes!

KSU NSF/LSAMP Director: Dr. PN Achar

Co-Director: Dr. R. Jones

Application materials:

§  Completed KSU LSAMP Scholars Program Application

§  Official Kennesaw State University Transcript

§  Copy of your resume

§  Copy of current Semester Course Schedule

LSAMP Scholars Application /

PERSONAL INFORMATION

First Name: ______Middle Initial: _____Last Name: ______

KSU ID:______Intended Major:______Cum. GPA: ______

Year: ______E-Mail:______Phone: ______

Home Address: ______

Mailing Address (If different from home address): ______

______

Expected Graduation Date (Semester/Year): ______

Have you ever convicted of anything other than a minor traffic violation? ______

If so, explain?

ACADEMICS

Briefly describe your specific career goals in STEM.

Circle three of the following subjects which you feel most knowledgeable about:

CALCULUS ALGEBRA BIOLOGY CHEMISTRY TECHNOLOGY PHYSICS BIOCHEMISTRY GENETICS MICROBIOLOGY ECOLOGY STATISTICS

Would you be willing to tutor an LSAMP scholar in any area you circled? Yes No

LSAMP Scholars Application /

Semester Plan: Which best fits your plans for this semester? (Please check one)

Freshman and Sophomore:

______Shadowing ______Lab Assistant

Juniors and Seniors:

______Contributing Researcher (group work) ______Research Project (solo)

WORK HISTORY

Have you held any jobs in the past 2 years?

Are you currently employed?

List your last three employers starting with your most recent one. If currently employed, write “still employed” in the Years of Employment section:

Name of Employer / Telephone / Supervisor / Years of Employment

FACULTY RECOMMENDATIONS

You must provide two faculty recommendations on this section.

Name of Applicant:

Signature of Applicant: ______Date:______

FIRST FACULTY RECOMMENDATION:

This program is designed for students who achieve more than what is expected of them. It is imperative for the success of this program that we select the most responsible, professional, and hard-working individuals for this program. The success of their co-workers and high school students depends on each individual’s work ethic, academic achievement, responsibility, and commitment.

Would you recommend the person whose name appears on this application for a position with Kennesaw State University’s LSAMP Scholars Program? If so, please fill out the portion below:

Name: ______Department: ______

Signature: ______Date: ______

SECOND FACULTY RECOMMENDATION:

This program is designed for students who achieve more than what is expected of them. It is imperative for the success of this program that we select the most responsible, professional, and hard-working individuals for this program. The success of their co-workers and high school students depends on each individual’s work ethic, academic achievement, and responsibility on our staff.

Would you recommend the person whose name appears on this application for a position with Kennesaw State University’s STEM Scholars Program? If so, please fill out the bottom portion below:

Name: ______Department: ______

Signature: ______Date: ______

LSAMP Scholars Application /

PERSONAL STATEMENT

Write a brief two paragraph statement below as to why you would like to participate in the KSU STEM Scholars Program and why you feel you have the best qualifications over other applicants.

DECLARATION

I, ______, confirm that the information above is accurate to the best of my knowledge. I also confirm that the faculty recommendations are for myself. I realize that if accepted, I will be contacted via the e-mail address that I have provided above to notify me as to whether I have been accepted or not. I acknowledge that I will have no more than 2 business days to accept my position before it is given to another applicant. Further, I acknowledge that LSAMP will contact me by email through the semester and I am obligated to read and respond to all appropriate mails.

Signature:______Date:______

Application Due in 2nd Week of each Semester

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