Clare Boothe Luce Scholarship

College of Saint Benedict

Application Form

I, ______by completing this form understand that I am applying for a Clare Boothe Luce Scholarship and confirm my wish to be considered. I give my permission for a transcript of my academic record and other requested material to be reviewed by a faculty panel from CSB/SJU.

I affirm that I plan to pursue a research career in mathematics, the natural sciences, computer science, or engineering as defined and discussed in the application information.

I affirm that I do not plan to attend medical school

I affirm that the information contained in my application is true and accurate to the best of my knowledge and belief.

Date ______Signature ______

The selection of scholarship recipients will be influenced by the completeness, neatness, and legibility of replies. This form and the essay may be typed or printed by computer.

Biographical Questionnaire

A. You, the applicant

Name (Last, First, MI) ______

School Address ______

______

School Telephone Number______

Date enrolled at CSB______

B. Your Schooling

What is your undergraduate major(s)? ______

What is your cumulative GPA? ______

What is the highest degree you plan to pursue? ______

What will be your area/field of specialization?______

In a few sentences, describe your career goal(s):

1. Beginning with CSB, list all schools you attended in the last four years, including any for summer or special courses. If more than four months elapsed between high school and entry into college, please specifically state your activities during that time. Also list any significant college work completed more than four years ago.

School / Location / Dates Attended / GPA/GPA scale

2. List courses in your major in which you are currently enrolled, courses in your major in which you plan to enroll before graduation, and courses in mathematics/science/computer science/engineering (MSCSE) outside your major in which you are currently enrolled or plan to enroll. List by both catalog number and title.

Courses in major/currently enrolled / Courses in major/plan to enroll / MSCSE enrolled/planned to enroll

3. List any awards, honors, or scholarships you have received.

C. Your Programs and Activities

1. List past and present research activities associated with your interests in mathematics/science/computer science/engineering in which you regularly participate. Explain the duration, degree, and significance of your involvement, including what responsibilities you had in the project. In the absence of formal research experience, describe briefly any other skills or accomplishments you consider significant and relevant to this application.

2. List activities in which you participated at your school (such as clubs, publications, debating, dramatics, music, art, and student government). Place an "X" in front of those activities you consider most important.

College Activity / Dates Participated / Offices Held

High School Activities (list two most significant)

3. List jobs (including summer employment) you have held in the past two years.

Job and kind of work / Employer / Dates of Employment (summer/school year) / Number of hours worked per week

D. What are your professional aspirations? Indicate in which area(s) of mathematics, science, or engineering you are considering making your career and specify how your current academic program and your overall educational plans will assist you in achieving this goal.

E. Describe an activity or experience that has been important in clarifying or strengthening your motivation for a career in science, mathematics, or engineering.

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