Robert Noyce Teacher Scholarship Application

Transcription

1 Robert Noyce Teacher Scholarship Application PERSONAL INFORMATION Name Last First M.I. CWRU Student ID# 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 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 word essay describing 1) how you came to the decision to pursue a career as a science or math teacher, 2) your personal and professional goals, 3) your commitment to working in a high-need school, and 4) your interest in your math or science discipline/s.. TRANSCRIPTS Include 1 copy of an official transcript from each higher education institution attended. REFERENCES Obtain 2 letters of recommendation using the Recommendation forms included with this application. At least one of the letters should be from a CWRU faculty member.

3 Case Western Reserve University Applicant Certification and Release of Information 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 certify that I meet all of the eligibility requirements and I understand that I must maintain a 3.0 or higher cumulative GPA and full time student status continuously at CWRU for the term of my scholarship. I understand that I must complete a major in a science or mathematics field and complete teacher licensure requirements for that field. I will apply for entry into the CWRU Teacher Licensure Program. 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 will fulfill the mentoring/tutoring requirement in an approved manner through consultation with the Noyce Teacher Scholarship Committee. I agree to fully participate in all outcomes assessment activities designed to evaluate the effectiveness of the CWRU Noyce Teacher Scholarship Program. I understand that I am obligated to teach full time as a certified teacher in mathematics or science in a high-needs public school district for two years for every year of scholarship support received and that this commitment must be completed within 8 years of graduation If I fail to complete the teaching obligation as specified, I must immediately repay the total balance of all Noyce scholarship money received. I authorize exchange or disclosure of information among CWRU, school districts, and the Ohio Department of Education, and other entities relating to teaching or working with children. Applicant Signature Date Applicant Name (printed or typed)

4 Robert Noyce Teacher Scholarship Recommendation Form Applicant s Name: The person named above is applying for a Robert Noyce Teacher Scholarship. Recipients receive substantial scholarships for tuition to become high school mathematics or science teachers. Please submit a letter of recommendation for this student. Your candid responses will assist the selection committee in choosing the CWRU Noyce Scholars. Please include in your letter an explanation of your knowledge of the applicant, along with assessments in the following areas: 1) Leadership, 2) Integrity and moral character, 3) Intellectual strength, 4) Communication skills, and 5) Interpersonal abilities. Thank you. CWRU Robert Noyce Teacher Scholarship Selection Committee Please submit the letter of recommendation via fax, campus or U.S. mail by February 18, 2009 to: Edward Bernetich Director of Teacher Education Case Western Reserve University Euclid Avenue (Mather House Room 1) Cleveland, Ohio Phone: Fax: edward.bernetich@case.edu The CWRU Robert Noyce Teacher Scholarship Program is funded by the National Science Foundation

5 Robert Noyce Teacher Scholarship Recommendation Form Applicant s Name: The person named above is applying for a Robert Noyce Teacher Scholarship. Recipients receive substantial scholarships for tuition to become high school mathematics or science teachers. Please submit a letter of recommendation for this student. Your candid responses will assist the selection committee in choosing the CWRU Noyce Scholars. Please include in your letter an explanation of your knowledge of the applicant, along with assessments in the following areas: 1) Leadership, 2) Integrity and moral character, 3) Intellectual strength, 4) Communication skills, and 5) Interpersonal abilities. Thank you. CWRU Robert Noyce Teacher Scholarship Selection Committee Please submit the letter of recommendation via fax, campus or U.S. mail by February 18, 2009 to: Edward Bernetich Director of Teacher Education Case Western Reserve University Euclid Avenue (Mather House Room 1) Cleveland, Ohio Phone: Fax: edward.bernetich@case.edu The CWRU Robert Noyce Teacher Scholarship Program is funded by the National Science Foundation