Purpose

T-STEMAPPLICATION

TheTexas Science,Technology, Engineeringand Math (T-STEM) ChallengeScholarship program

fundedbytheTexas HigherEducation CoordinatingBoard atCedarValleyCollege, DCCCD, provides fundingfor high-achieving,eligiblestudents pursuingatwo yeardegreeor a30 hr. certificateinthe

STEM field disciplines. Pleaseseepage5 for alistofeligibleCVCT-STEM disciplines.

Benefits

Studentselected asSTEMScholarwillreceiveanopportunityto intern and explore careersand network with other STEMstudents,facultyandindustryprofessionals.

Studentwillbe eligibleformerit-based awards of$1,450 totaloverthe academicyear based on meeting

eligibilityandparticipationcriteria.Please Note: ifyouapplyfor otherfinancialaid(via the FAFSA application)andareeligible other awards maybe adjustedifyou are alsoawarded the T-STEM scholarship.

Requirements

Be a Full-Time Studentwith acumulative 3.0 GPAorhigher.

(Males)Registered with theSelectiveServiceSystem Service.

http://www.sss.gov/default.htm

Maintain aprogramof studyleadingtoan AS oran AAS degreewith CedarValleyCollege.

Willcompletea minimumof 30credithoursforthe academicyearyou areapplyingfor (fall, spring, summer)

Participate byvolunteeringor interning1-15 hour per weekpersemester in a STEM discipline thatyou have selected or underthe guided programvia CVC.

Recommendation Letterfroma Math or ScienceFaculty.

Application Documents.

1.Complete the STEMApplication,selectProgramofStudy(POS)in E-connect,

2.Officialtranscript.

3.Copyof Selective Services registrycard.

4.Recommendation letter froma Science orMathinstructor.

T-STEM ChallengeScholarshipApplicationInstructions

Please completethe followingsections.Whencompleted, pleasesign, initial whererequested,

date and submit to theofficeidentified on page1 of this packet.

ApplicantInformation

First Name:

Last Name:

DCCCD Student ID#Date of Birth:

HomeAddress:City:State:Zip:

Cell Phone:PrimaryEmailAddress:

*The“PrimaryEmailAddress”youprovideherewillbeusedasacentralsourceofcommunicationswiththeCedarValleyCollege.YouagreetocheckyourprimaryemailtoreviewanymessagesfromtheCVCSTEPProgram.YoualsoagreetonotifytheCVCSTEMprogramimmediatelyofanychangesinyour“PrimaryEmailAddress”.

AcademicInformation

Intended STEM Major (seepage5 of application):

CollegeCredit Hours Earned to Date:CumulativeCollege HoursGPA: Haveyou registeredwith theSelectiveServices System?

Doyou intend to take10-12 credit hourseach semester (summers 6 hours)Doyou intend tograduatefrom DCCCDwith anAAS or ASdegree?

Ireleasetothe Dallas CountyCommunityCollege District(DCCCD) and theCVCSTEMprogramthe

rightto access allmycurrentandongoingpersonaland academic recordsandtranscripts. If awarded a studentsupportaward,IunderstandthatImustmeetthe awardcriteria and Standards of Academic Progressforthe DCCCDand theCVCSTEM program.Iunderstand myname and information from my academic historymaybe releasedto the studentsupportaward selection committee(s) andthestudent supportaward donor(s). If awarded a studentsupport award, Ireleaseto the DCCCDand theCVCSTEM program, the righttoarrange a meetingwith the donor(s)and use myname, story, and pictureforprinted and video materials,reports, and pressreleases,withoutcompensation, as wellas Iwillattend ceremonies and receptions.

AuthorizationandInformation

(Yourinitials)

Date:

I certify that thestatements hereinaretrueto thebest of my knowledgeand grant my permission forthe information containedhereinto be shared with thestudent support award selection committee(s) and student support award donor(s)

Student Signature:Date:

CVCSTEMAPPLICATIONQUESTIONNAIRE

(Your answer is usedfor informationalpurposes andwillnotimpact thedecisionof theselectioncommittee) fromDCCC

It is recommendedthattypeyour answerto thesequestions on aseparatepage andattachyour answer page(s) to the application.

1.Inoneortwolinesdescribewhatyourcareergoal(s)areasaSTEMProfessional?

2.InoneortwolinesdescribethereasonsforyourinterestintheSTEMfield.

3.InoneortwolinesdescribewhatyouhopetoaccomplishasaprofessionalinaSTEMfield?

4.InoneortwolineswhatwouldbemostvaluabletoyouasaSTEMScholarandwhy?

PROFILEAND COMMITMENTAGREEMENT

STEMSCHOLARPROFILE INFORMATION(Pleasetypeor print clearly.)

Name:DCCCDStudent ID#:

PhoneNumber(s):PrimaryEmail Address:

Declared STEMfield orprimary area ofstudy: DCCCDCollege Attending:

Will yoube employed during theacademicyear you areapplying for?Ifyes:

Full--time

Areyou receiving financial aidorany additional awards otherthe Pellduring the academic yearyou areapplying? YES. NO. (student only getting Pell awardarenot affected)

NOTE:Students that are eligible forthe following awards (TEXAS Grant, Federal Supplemental Education Grant, Work-Study, Subsidized Loan etc.) may havetheiraward adjusted ifalso awarded the T-STEM.

Initial

STEMSCHOLARCOMMITMENT AGREEMENT

Please review the requirementsofthe STEM Institute listed below.Then, initialnexttoeach itemas an acknowledgmentof your commitmentto satisfyeach requirement. Failureto meetthese requirements will resultin areductionorlossof the award.

I willmaintaina programof studywith DCCCDin anapproved STEMfield (see the liston pagetwo).

Ihave a 3.0 GPAor higherand Iagree to maintain acumulative 3.0 GPAor higherthrough the academic year. Iagree tocompleteaminimumof 10-12 credithourseachsemester (fallandspringacademic year) either working, volunteering or interning in a STEM related field.

Iunderstandthatfailure tomeetthese requirements willresultina reduction orlossof myaward.

Initial

YourSignature:Date:

STEM ANDRELATEDFIELDS

T-STEM ELIGIBLEINSTRUCTIONALPROGRAMS

T-STEMInstructionalPrograms area defined set ofcourses thatlead to the award an associate degreein thefollowingU.S. Department of Education Classification of Instructional Programs or specified bythe college.

Computer andInformation Sciencesand Support Services(AAS) COMPUTER GRAPHICS

Engineering

EngineeringTechnologies/Technicians) Biological Sciences

MathematicsandStatistics ACCOUNTING

Physical Sciences:

Multi/InterdisciplinaryStudies, Biological andPhysical Sciences VeterinaryTechnology (AAS Degree)

ResidentialBuildingPerformanceTechnology(AAS Degree)

AIR CONDITIONINGANDREFRIGERATION-RESIDENTIAL(AASDegree)

T-STEM OCCUPATION FIELDS

T-STEMOccupation Fields serve as a guidefor part-time employmentforactive T-STEMscholarship recipientsandfor continuedeligibilityof anAwarded Applicant basedontheemploymentof graduates.

T-STEMOccupation Fields area set of employment specialtiesas defined bythe Bureau of Labor Statistics as Standard Occupational Classification(SOC)Titles and include:

Computer and Mathematical Occupations Engineers

EngineeringTechnicians Life Scientists