Robotics Academy 2011 Cadet Program Applicant Form
Robotics Academy 2011 Cadet Program Applicant Form
(For college students only)
June 13 through August 19 2011
This application is only for college students wishing to participate in the Robotics Academyheld at NASA Ames Research Center in Northern California. This data will not be shared with other NASA internship programs.
Principal Requirements
In order to be considered for the program, applicants must:
- Have demonstrated interest in our space program
- Have experience in robotics
- Be a U.S. Citizen or have a valid Green Card indicating you are a United States Permanent Resident
- Be in high academic standing (GPA 3.0 or greater)
- Be a student at an accredited college or equivalent institution.
Desired Qualifications
The ideal candidate will have strong academic achievement in math, science, and technology, and formal experience in the field of robotics.
Eligibility and Contact Information
1. Student Information:
First Name: ______
Middle Name: ______
Last Name:______
Email: ______
(Provide an email address that you will check regularly and that will serve as a reliable means of communication before, during, and after the Academy.)
Home Phone:______Mobile Phone:______
Other Phone:______
(Provide a number(s) that is checked regularly and that can receive messages.)
2. Citizenship and Location:
Citizenship: ______Home State: ______
If you are a Permanent Resident, then provide the following:
Card Number: ______Country of Origin: ______
If you answered “neither” to this question then STOP. Non-U.S. Citizens and non-Permanent Residents are not eligible for this program.
3. Demographics:
Age as of June 13, 2011: ______Gender: ______Race:______
Disabilities: ______
______
4. Academics:
Year (You will enter Fall 2011): ______
Total Credits: ______Overall GPA: ______Scale: ______I do not have a GPA: Y / N
Institution Name: ______
Street: ______
City: ______State: ______Zip: ______
5. Legal Home Address:
Street: ______
City: ______ST: ______Zip:______
Relevant Programs, Skills, and Experience
6. Have you actively participated in any of these robotics programs?
NASA Ames Robotics Academy alumnus: Year(s)______
FIRST:
Year(s) ______Location ______Team # ______
Botball:
Year(s) ______Location ______Team # ______
VEX:
Year(s) ______Location ______Team # ______
Other (Describe): ______
Short Essay Questions
(We seek quality, not word count.)
7. In 250 to 500 words, please explain why you are applying for a NASA internship. Include your interests, your reasons for pursuing these interests, your experience, and your plans for the future.
8. Is there anything else, not on your resume or covered elsewhere, which you would like us to consider when evaluating your application?
Letters of Recommendation
9. Please list 2 references we can contact that can attest to your academic, technical, and personal accomplishments. Also, please have them email a letter or recommendation to :
1. Name:______
School/Company/Institution: ______
Address: ______
City: ______ST: ______Zip: ______
Email: ______
Phone: (_____) ______- ______
Title / Relationship: ______
2. Name: ______
School/Company/Institution: ______
Address: ______
City: ______ST: ______Zip: ______
Email: ______
Phone: (_____) ______- ______
Title / Relationship: ______
Important!
•Please include a copy of your resume and unofficial transcript.
•The applicant may mail this physically OR sign and scan then attach the completed application as a pdf.
Student Applicant Signature: ______Date: ______
Submit completed applications to Guy Chriqui:
NASA Ames Robotics Academy
NASA Ames Research Center
Mailstop T28B RM101
Moffett Field, CA 94035
Please direct all inquiries to Guy Chriqui:
2011 Robotics Academy – Application1