National Association of Geology Teachers

[Three page form may be printed as shown here.] National Association of Geoscience Teachers

Far Western Section

ANNUAL SCHOLARSHIP APPLICATION

Academically superior students currently enrolled in school in Hawaii, Nevada, or California are eligible to apply for one of three $500 scholarships to the school of their choice.

1. High school senior or community college students enrolling full time (12 quarter units) in a bachelor's degree program in geology at a four year institution.

2. Undergraduate geology majors enrolling in an upper division field geology course of approximately 30 field mapping days.(Dottie Stout Field Scholarship)

3. Graduate students enrolled in a Master’s or Doctoral degree program.

The application package is to consist of this form including official transcripts of your high school/community college work, (Scholarship #1) of college work (Scholarship #2) for field geology applicants, or graduate studies (Scholarship #3); two letters of reference from instructors who know your work, and the endorsement signature of a regular member of NAGT-FWS. Reference letters may be sent separately. FAXed, or e-mailed materials are not acceptable.

Send typed application to: Mike Martin, Martin Luther King H.S. 9301 Wood Road, Riverside, CA 92508

Deadline for receipt of all application materials is March 1. Awards are announced by April 20.

NOTE - Multiple applications for any one scholarship from a single school must be ranked by your department chair or endorsing NAGT-FWS member.

(Please type)

Name of Applicant:

______________________________________________________________________
Last First Middle

Permanent Mailing Address: (Use an address where you can always be reached, or mail forwarded reliably.)

__________________________________________________________________________________________

Current Phone Number___________________Home (or backup) phone number _______________

Social security number ______________________

School currently attending (Department, Name, Address, Phone)________________

___________________________________________________________________________________________

Circle class status (FF, So, J, Sr, Gr) and give cumulative GPA (A = 4) in High School _________ or Community College _________ (#1), or 4-Year College (#2)__________, or graduate school (#3) __________.

Other financial aid. Specify source, amount, and whether in process of application or already received.

___________________________________________________________________________________________

Previous academic honors and scholarships (Name, dates, and amounts, where applicable).

___________________________________________________________________________________________

Name, address, and phone number of college/university accepting your application (HIGH SHOOL/COMMUNITY COLLEGE APPLICANTS ONLY)

___________________________________________________________________________________________

Name and address of field camp sponsoring institution, and name and phone number of Director (UPPER DIVISION FIELD GEOLOGY STUDENTS ONLY)

___________________________________________________________________________________________

Name and address of GRADUATE SCHOOL where you have applied or have been accepted.

___________________________________________________________________________________________

Date ___________ Signature of applicant _________________________

Endorsement signature, address, and phone number of a regular NAGT-FWS member in your department who has reviewed this application. (REQUIRED)

___________________________________________________________________________________________

A GOOD APPLICATION IS NEAT, LEGIBLE, COMPLETE, AND HONEST.

(Late applications are not reviewed.)