Robert Noyce Teacher Scholarship Program Summer Internship Application
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1 Robert Noyce Teacher Scholarship Program Summer Internship Application PERSONAL INFORMATION Name Last First M.I. CWRU or Fisk Student ID# (Indicate your university) Campus Address: Street City State Zip Permanent Address: Street Gender: M F Campus Phone ( City State Zip Date of Birth / / Mo. Day Year ) Cell Phone ( ) CWRU/or Fisk Alternate CITIZENSHIP US Citizen: Permanent Resident Resident Alien Other ETHNIC IDENTITY (optional): You may check more than one. American Indian/Alaskan Native (Eskimo or Aleut) Hispanic / Latino American Indian Native Hawaiian Islander/Other Pacific Islander Asian White Black / African American Unknown/Unspecified
2 ACACDEMIC BACKGROUND Expected date of graduation Major: Major: Minor: Current Cumulative GPA: Current GPA in Science or Math Major: Proposed Teacher Licensure Area (Grades 7-12): Integrated Mathematics (Math major) Physics Life Sciences (Biology major) Chemistry Physical Sciences (Dual Field: Chemistry and Physics majors) Proficient in Other Languages? No Yes Language(s) PERSONAL ESSAY Attach a 300 word essay describing: 1) your experiences working with adolescents (coaching, tutoring, babysitting, mentoring, etc.), 2) your interest in a teaching career in math or science, 3) how you think a Noyce Summer Internship would benefit your education or career. TRANSCRIPTS Include 1 copy of any official transcripts from all higher education institutions attended. REFERENCES Obtain two letters of recommendation using the Recommendation forms included with this application. At least one of the letters should be from a CWRU faculty member if a CWRU student or a Fisk University faculty member if a Fisk University student.
3 Robert Noyce Teacher Scholarship Program Summer Internship Program Please read and initial that you understand and agree to each of the following statements. I certify that all of the information on this application is true and complete to the best of my knowledge. I have never been convicted of a felony. I am able to pass all criminal background checks, which are conditions for employment in Ohio public schools. (Both BCI and FBI, as mandated in Ohio House Bill 190) I understand that the Summer Internship Program will last for four weeks and pay a stipend of $1,700. I will be placed at CWRU, Shaker Heights High School, Cleveland Heights High School, or in the Cleveland Metropolitan Schools working with high school age students. I agree to fulfill all requirements of the program. Applicant Signature Date Applicant Name (printed or typed) Please submit the application form and essay by March 5, 2010 to:
4 Robert Noyce Teacher Scholarship Summer Internship Recommendation Form Applicant s Name: The person named above is applying for a Robert Noyce Teacher Scholarship Summer Internship. Interns will receive a stipend and work in school-based assignments for four weeks. Please submit a letter of recommendation for this student. Your candid responses will assist the selection committee in choosing the CWRU/Fisk Noyce Scholars. Please include in your letter an explanation of your knowledge of the applicant, along with assessments in the following areas: 1) Integrity and moral character, 2) Intellectual strength, 3) Communication skills, and 4) Interpersonal abilities. Thank you. CWRU/Fisk Robert Noyce Teacher Scholarship Selection Committee Please submit the letter of recommendation via fax, campus or U.S. mail by March 5, 2010 to: Fax:
5 Robert Noyce Teacher Scholarship Summer Internship Recommendation Form Applicant s Name: The person named above is applying for a Robert Noyce Teacher Scholarship Summer Internship. Interns will receive a stipend and work in school-based assignments for four weeks. Please submit a letter of recommendation for this student. Your candid responses will assist the selection committee in choosing the CWRU/Fisk Noyce Scholars. Please include in your letter an explanation of your knowledge of the applicant, along with assessments in the following areas: 1) Integrity and moral character, 2) Intellectual strength, 3) Communication skills, and 4) Interpersonal abilities. Thank you. CWRU/Fisk Robert Noyce Teacher Scholarship Selection Committee Please submit the letter of recommendation via fax, campus or U.S. mail by March 5, 2010 to: Fax:
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