National Coalition of 100 Black Women, Inc.

Silicon Valley Chapter

Pathfinder: Science, Math & Technology (P:SMT) Program
2015 Sponsorships for 4th-8th Graders

What is the P:SMT Scholarship Program?

The P:SMT scholarship program is an innovative education/recreation program designed to increase the number of girls of color interested in science, math and technology and to encourage them to pursue opportunities and careers in those areas.

Who is eligible?

Eligible students for the P:SMT Scholarship Program for 2015 are females of African American descent, who are presently in grades 4-8 and who are historically underrepresented in the areas of science, math, and technology.

How does the program work?

The focus of the program is to stimulate learning and continue the girls’ interest in the aforementioned subjects. The P:SMT Program offers scholarships to girls in the 4th through 8th grades. Selected 4th graders and 5th graders attend a one-day science camp in the spring. Selected 5th-8th graders spend a week in a residential summer camp and participate in innovative activities. The girls also participate in follow-up activities initiated by the National Coalition of 100 Black Women, Silicon Valley Chapter (NCBW-SVC).

Which camps participate in the P:SMT Program?

·  Camp MayMac (overnight camp; June 19-20, 2015)

·  ID Tech Camp at Stanford University

·  Tech Trek Camp at Stanford University

Submit documents by March 14, 2015 to

NCBW-SVC, Attn: P:SMT Application

PO Box 730907, San Jose, CA 95173

If you have questions, contact:

Applications returned by certified, registered or any signature-required mail service will NOT be accepted.


STUDENT APPLICATION

Student Information:

Name:

Grade: Age: Birthday:

School Information:

Name of School:

County:

Teacher:

Favorite Subjects:

Parent or Legal Guardian Information:

Name:

Address:

City: ZIP Code:

Phone (Home):

Work: Cell:

Email:

Single parent? Yes No

Foster parent? Yes No

Number in family:

Does student have health condition Yes No

If yes, please describe:

Does student participate in lunch program? Yes No

If yes, at what level? Free Reduced fee

I am willing to volunteer with NCBW. Yes No

Parent or legal guardian signature:

Date:


Applicants are required to submit the following:

q  Scholarship application

q  A drawing (mandatory for 4th graders, extra credit for others) depicting why you want to participate in the P:SMT program

q  A written paragraph (5th-8th graders) describing how you would benefit from the P:SMT program

q  1 Letter of Recommendation from teacher/school official

q  1 Letter of Recommendation from parent/legal guardian

q  Completed Letter of Consent

q  Completed Photo/Video/Film Release Form

q  And STEM Day RSVP form

q  See page 2 for additional details

The letter of recommendation from a teacher or school official

q  Must be submitted on school letterhead in a sealed envelope

q  Must include information on applicant’s participation in group activities, academic achievements, and recent academic improvements

q  Must state how the teacher or official perceives the student would benefit from the P:SMT program

Letter of recommendation from parent(s) or legal guardian(s)

q  Must provide information on applicant’s academic and personal interests

q  Should include any extenuating family or medical circumstance pertaining to the applicant they deem essential

q  Must also state how daughter would benefit from participation in the P:SMT program

CAMP DESCRIPTIONS

(All subject to availability)

Applications are due March 14, 2015. Please fill out application completely and legibly! Mail applications via first class mail to:

NCBW-SVC

Attn: P:SMT Application

PO Box 730907

San Jose, CA 95173

Do not send application packet via FedEx, UPS, or any other delivery method that requires a signature

In order to be considered for a scholarship, applicants are expected to participate in the following activities:

·  2015 STEM Day: TBA

·  Oral interviews: May 2, 2015

Note: application packets will be screened to determine which applicants will move on to the interview phase

·  Camp orientation: May 30, 2015

Poster Template for 4th Graders (extra credit for other grades)
Drawing should depict why you would like to participate in the P:SMT program. Deadline: March 14, 2015

CAMP DESCRIPTIONS

(All subject to availability)

The P:SMT Scholarship Program is a collaborative partnership between NCBW-SVC and existing programs that provide fun, exciting and innovative learning activities for young girls, grades 4-8, who are interested in science, math, and technology subjects. NCBW-SVC provides scholarships that allow young female students the opportunity to attend residential and non-residential science camps, as well as other related activities during the school year. The following is a brief description of our camps.

Overnight Science Camp – 4th grade (Summer 2015)

CityTeam Camp MayMac

Location: Santa Cruz

Camp MayMac has been serving children and youth from the San Francisco Bay area for the last 35 years. The camp is located in the Santa Cruz Mountains near Scotts Valley and has 178 acres of rolling hills and beautiful trees along with the developed sports and activity areas. The activities are age appropriate and programming is distinct in nature.

One-week residential camps – 5th-8th grades (Summer 2015)

Internal Drives (ID) Tech Camp

Location: Stanford University

This is a cutting edge camp that immerses students in the power of technology while having a blast. The curriculum focuses on 4 high tech areas. They are: multimedia, web design, movie production and software programming. Parents should plan to attend parent’s night. They will be absolutely amazed.

Tech Trek Science Camp

Location: Stanford University

This is a science and math camp designed to develop interests, excitement and self-confidence in young girls. Students are assigned either to a math or science core class daily. Camps feature hands-on activities and off-site field trips. Astronomy, engineering, marine biology, environmental studies, and other subjects supplement and enhance the learning experience.


Letter of Parental Consent

Please read carefully before signing.

As the parent or legal guardian of , I hereby give the National Coalition of 100 Black Women, Silicon Valley Chapter (NCBW-SVC), permission to consider her for selection as a 2015 P:SMT scholar. I understand that scholarships will be awarded following an announced selection process with subjective criteria. I understand that all qualified applicants may not be able to attend as capacity for the program is limited. I am aware that my daughter may not be chosen to participate or may be chosen as an alternate. I understand that the cost (tuition) of my daughter’s participation will be provided by NCBW-SVC.

If selected as a P:SMT scholar, I agree that my daughter will comply and cooperate with all conditions for participation, including camp regulations, terms, and conditions set forth by NCBW-SVC as well as follow-up interviews and questionnaires for five years following participation in the program.

I/we consent to allow my/our daughter to purchase any insurance required by the local site or participating program. I/we the parent(s)/legal guardian(s) of further understand and agree that my/our daughter will conduct herself in a manner representative of the standards set forth by the NCBW-SVC. I understand that the P:SMT Activities Program represents several programs or camps and is the result of a collaboration between NCBW and several other groups that focus on science, math and technology activities for young girls. I also understand that these programs and/or camps will be held in various cities in Santa Clara and San Mateo Counties. The programs may be located on college and university campuses and other places throughout the Silicon Valley.

I/We agree if my/our daughter is selected, I/we will take full responsibility for getting her to and from one (1) of these locations as deemed appropriate by NCBW and/or the participating program. I/We understand by signing this Letter of Consent, that I/we release the NCBW-SVC (the national organization and any of its local and state affiliate chapters) from any medical, personal, or accidental liability regarding my/our daughter’s participation in the Pathfinder: Science, Math, and Technology (P:SMT) Activities Program during the year of 2015 and any of its follow-up activities.

I/We understand and accept that this opportunity is a good faith effort on behalf of the NCBW Silicon Valley Chapter to enhance my/our daughter’s interest in math, science and technology, and to increase her awareness of career possibilities relating to these subjects or areas of study.

Date

Date

Signature of Parent(s)/Legal Guardian

Date

Signature of Representative of NCBW, Silicon Valley Chapter


Photo/Video/Film Release

The Pathfinder: Science, Math, and Technology (P:SMT) Activities Program represents several programs and/or camps throughout the Silicon Valley. The programs may be visited by the news media, video and film crews or by professional photographers hired by the programs for the purpose of publicity and promotion. The National Coalition of 100 Black Women, Inc., Silicon Valley Chapter (NCBW-SVC), P:SMT Activities Program may be active during these times. There is a possibility that your daughter, as a P:SMT Scholarship recipient, may be included as part of these activities. The NCBW-SVC will also use various types of media to document its Pathfinder: Science, Math, and Technology (P:SMT) Activities Program. Therefore, we ask that you please read, complete, and sign the information listed below.

I/We , the parent(s)/legal guardian(s) of
, do hereby give consent to authorize the NCBW-SVC, or any entity or person authorized or designated by it, the right to take, use, and reproduce any and all photographs, video, or film taken of my/our daughter during the P:SMT Activities Program, 2015 and/or follow-up activities. This also includes publication and distribution of training materials, events held in the community and other NCBW-SVC related activities.

I/We understand and accept that there will be no compensation to me/us and/or my/our daughter now and/or in the future. I/We wave any right to inspect or approve any photo, video, or film taken during my/our daughter’s attendance at the P:SMT Activities Program, 2015 and/or follow-up activities. All negatives and positives, together with said prints, videos, and/or film are the exclusive property of the NCBW-SVC, or the entity or person authorized or designated by it, solely and completely.

I/We affirmatively release and discharge the NCBW-SVC from responsibility for any distortion or manipulation, whether intentional or otherwise, of photos, video, or film taken of my/our daughter during her attendance at the P:SMT Activities Program, 2015 and/or follow-up activities.

Name of P:SMT Scholarship Recipient:

Age of P:SMT Scholarship Recipient: Date:

Date

Signature of Parent(s)/Legal Guardian(s)

Save the idea: 2015 ncbw stem day

The National Coalition of 100 Black Women-Silicon Valley Chapter is currently planning our annual STEM Day, a fun-filled day with the purpose of energizing and encouraging young girls of color in the 4th-8th grades to appreciate and access the science, technology, engineering and math subjects and as well as careers. Please refer to our website www.ncbwsiliconvalley.org on March 14th, 2015 for more details regarding location, time and date. Thank you for your continued support!