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Society of Women Engineers Connecticut Section
Scholarship Committee
PO Box 1053
New Canaan, CT 06840-1053

Jean R. Beers Scholarship Application Academic Year 2013-2014 (SWE FY13)

The Jean R. Beers Scholarship is a $1500 tuition award for female college students pursuing Baccalaureate degrees in Science, Technology, Engineering or Mathematics enrolled full-time during the school calendar year 2013 - 2014.

All portions of applications must be postmarked or emailed by February 15, 2013.

In addition, applicants must reside or attend a college/university within the SWE Connecticut Section, which is bounded by the following zip codes.

Please CIRCLE the appropriate zip code:

Any Zip code starting with: / 065__ / 066__ / 068__ / 069__ (fill in the blanks),

Or, one of the below:

Starts with 060: / Starts with 064: / Starts with 067:
06039 / 06401 / 06426 / 06468 / 06484 / 06702 / 06716 / 06753 / 06784
06068 / 06403 / 06430 / 06470 / 06487 / 06703 / 06720 / 06754 / 06785
06069 / 06404 / 06431 / 06471 / 06488 / 06704 / 06721 / 06755 / 06786
06079 / 06405 / 06432 / 06472 / 06490 / 06705 / 06722 / 06757 / 06793
06409 / 06436 / 06473 / 06491 / 06706 / 06723 / 06762 / 06794
06413 / 06437 / 06475 / 06497 / 06707 / 06724 / 06770 / 06795
06418 / 06440 / 06477 / 06498 / 06708 / 06725 / 06776 / 06796
06419 / 06442 / 06478 / 06709 / 06726 / 06777
06424 / 06443 / 06482 / 06710 / 06751 / 06779
06425 / 06460 / 06483 / 06712 / 06752 / 06783

1.  Personal Data:

Name:
Current Address:
City: / State: / Zip Code:
Permanent Address:
City: / State: / Zip Code:
Home Phone: / Cell Phone:
School Phone: / E-mail address:

***PLEASE DO NOT PLACE ANY PERSONAL DATA INCLUDING YOUR NAME ON FURTHER PAGES EXCEPT THE FINAL PAGE***

2.  Educational / Financial Data:

High School Attended: / College/University Attending 2012-2013 Academic Year:
Current GPA/GPA Scale: / College or University Attending Fall Semester 2013:
Major: / Degree Expected: / Expected Graduation Date: / Credits Required: / Credits Completed:
Enrolled In:
2 year program
4 year program
5 year program
Other / Currently In:
1st year
2nd year
3rd year
4th year
5th year
Other / Anticipated Expenses for Next Academic Year:
Tuition $
Room Board $
Books & Supplies $
Transportation $
Other $
TOTAL $ / Source of Income for Next Academic Year:
Parents/Family %
Scholarships %
Loans %
Employment %
Work/Study %
Other %

3.  Transcript:

Applicant must submit an official copy of their most recent college transcript for consideration.

4.  Applicant’s Statement:

A statement or essay written by the applicant, NO MORE THAN ONE (1) SINGLE-SIDED 1.5-SPACED TYPED PAGE, describing one or more:

  1. Why she chose a major in Science, Technology, Engineering or Mathematics
  2. How she believes she will make a difference in her chosen profession.
  3. Explain what influenced her to study in her chosen field.

*PLEASE do NOT put your name in the personal statement page document, just in the file name if it is a separate document*

5.  Professional Data and Other Relevant Data: Please attach a 1-page resume including a brief description of any work or volunteer experience, and any other pertinent information. Include any AWARDS (Names/Years) and/or other activities, research projects, design projects, design teams, interests, hobbies or other pertinent information.

6.  Certification: I hereby certify that all of the above an any supplemental information is true, and that I intend to be enrolled as a full time student with a major in Science, Technology, Engineering or Mathematics in September 2013. I further certify that I am not receiving full funding for my education from an employer, any branch of the Armed Services or other organization. By submitting this application I understand that such information is confidential and subject to verification by SWE Connecticut.

______

Signature or Typed Signature Date

Please submit your application, preferably via email to , or mail to:

Society of Women Engineers Connecticut Section

Scholarship Committee

PO Box 1053

New Canaan, CT 06840-1053

For up to date information please visit www.swect.org
Any questions please email