Louis Stokes Alliance for Minority Participation Math Honors Program Summer 2015 Program Description: California State University, Sacramento (Sacramento State), through its Science Educational Equity (SEE) Program, will be offering a Math Honors Program (Math AMP) for students eligible to participate in the California State University-Louis Stokes Alliance for Minority Participation Program (CSU-LSAMP) at Sacramento State. CSU-LSAMP is a state-wide program supported by the National Science Foundation (NSF Grant # HRD-1302873) and the CSU Chancellor s Office, which is designed to broaden participation in science, mathematics, engineering and technology (STEM) disciplines. The LSAMP Math Honors Program consisting of a three-week summer session scheduled for August 3 -August 21, 2014, and depending on the student's level of readiness will be followed by a either a unique two semester pre-calculus course (Math 29A and 29B) or a year of calculus (Math 30 and 31), which includes enrichment workshops ("math labs") during the 2015-2016 academic year (in addition to major and general education courses). LSAMP students will also be active members of the MESA Engineering Program (MEP) or the Science Educational Equity (SEE) program. Student Support: Students selected for the program will receive compensation up to $675 for active participation in the LSAMP Math Honors Program. Please note that the amount of compensation is based on attendance, participation in activities, and completion of assignments. Eligibility: To participate in the program students must - Be a U.S. Citizen or Permanent Resident Be an individual who faces or has faced social, cultural, educational, or economic barriers to careers in the fields of science, technology, engineering/computer sciences, and mathematics. Be newly admitted to or be a continuing student at California State University, Sacramento. Be an undergraduate student pursuing a first bachelors degree in a science, technology, engineering/computer sciences, or math major. Demonstrate an interest in pursuing a research career, Have a G.P.A. of 2.5 or better and a minimum SAT score of 400 in math or an equivalent assessment score. For additional information or to request an application package, please call the Science Educational Equity Program at CSU, Sacramento (916) 278-6519 or the MESA Engineering Program (MEP) at (916) 278-6699.
INSTRUCTIONS TO THE APPLICANT: If you have any questions or would like assistance in completing the application, please call the Science Educational Equity Program (SEE) at (916) 278-6519 or MESA Engineering Program (MEP) at (916) 278-6699. After hours, you may leave a message at (916) 278-6519 and your call will be returned. 1. Complete the enclosed Application Form. 2. Include a copy of high school/college transcripts. 3. Include a copy of SAT/ACT scores. 4. Must provide a current Intermediate Algebra Diagnostic (IAD) or Calculus Ready (CR) score. Note: Admitted students will take one during their orientation or should make arrangements in June to take the diagnostic test. 5. Answer the questions on the enclosed Personal Statement Form. 6. Recommendation Forms: Two recommendations (at least one from a teacher) are required. 7. Complete commitment/release form included in this application packet Please have each person complete the enclosed recommendation form and submit it directly to the LSAMP program or have them give it to you in a sealed envelope with their signature for inclusion with the application materials. Send all application materials to: LSAMP Math Summer Program Science Educational Equity Program California State University, Sacramento 6000 J Street, Sequoia Hall 315 Sacramento, CA 95819-6119 Phone Number: (916) 278-6519 Fax Number: (916) 278-4640 For priority consideration application must be submitted by Friday, June 12, 2015. Math Honors Program Page 1 4/21/2015
Please type or print (Black or Blue ink only) legibly entire application for consideration Personal Information Full Name: Address: Last First M.I. Street Address Apartment/Unit # City State ZIP Code Home Phone: Alternate Phone: Email SSN Sacramento State SID# Birth Date: Expected or Current Major: Name of Last School Attend Place of Birth: Career Interest Test GPA Scores Verbal SAT/ACT Score Math SAT/ACT Score Citizenship Status I am a:u.s. Citizen Permanent Resident Other Race and Ethnicity: 1) Are you Hispanic or Latino? Hispanic or Latino (A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race) Not Hispanic or Latino Decline to State Math Honors Program Page 2 4/21/2015
Race and Ethnicity Cont.: 2) Regardless of our answer to question 1, please select one or more of the following racial categories: Black or African-American - A person having origins in any of the black racial groups in Africa Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, Polynesia, Micronesia, or other Pacific Islands American Indian - A person having origins in any of the original peoples of North America and maintaining cultural identification through tribal affiliation or community recognition Alaska Native - A person having origins in any of the original peoples of Alaska, including Eskimos or Aleuts Asian - A person having origins in any of the original peoples of East Asia, Southeast Asia, or the Indian subcontinent. This area includes, for example, China, India, Indonesia, Japan, Korea, and Vietnam White - A person having origins in any of the original peoples of Europe, North Africa, or the Middle East Other (specify): Decline to State List all math courses you are taking or have completed in High School or College Course Grade Received Please list the names and titles of persons who will submit recommendations on your behalf Name Title Math Honors Program Page 3 4/21/2015
In the space below or on a separate sheet of paper, please answer the following questions. a. Describe any cultural, social, or economic barriers you have faced in your pursuit of higher education? b. Why are you interested in science, engineering or math? c. Describe an experience where you were proud of yourself for a personal accomplishment. d. Why are you interested in the LSAMP program, what do you expect to gain from participating in the program? e. Describe how your participation in CSU-LSAMP will contribute to the program's goals of broadening participation in science, mathematics, engineering and technology (STEM) disciplines? Math Honors Program Page 4 4/21/2015
Commitment/Release Form Name: PROGRAM COMMITMENT If selected for the Louis Stokes Alliance for Minority Participation LSAMP program, I am prepared to fully participate in all program activities. I am aware that the LSAMP is a challenging, honors program. I am prepared to commit myself and my time to it. Signature: Date: Releases: By signing below, I authorize use and public display of any photographs taken of me during my participation in the LSAMP Program. In addition, I authorize the project to track my progress in higher education and to provide contact information to other educational institutions with the goal of advancing my progress in my educational career. This includes tracking which requires use of my Social Security Number as identifying information. Signature: Date: FOR OFFICE USE ONLY: Application Received Staff Initial: This Student is: Accepted Not Accepted Action taken by: Print name Title Signature Date Math Honors Program Page 5 4/21/2015
Recommendation Form California State University, Sacramento (Sacramento State), through its Science Educational Equity (SEE) Program, will be offering a Math Honors Program for students eligible to participate in the California State University-Louis Stokes Alliance for Minority Participation Program (CSU-LSAMP) at Sacramento State. CSU-LSAMP is a state-wide program supported by the National Science Foundation (NSF Grant # HRD-1302873) and the CSU Chancellor s Office, which is designed to broaden participation in science, mathematics, engineering and technology (STEM) disciplines. The LSAMP Math Honors Program consisting of a three-week summer session scheduled for August 3 - August 21, 2015, and depending on the student's level of readiness will be followed by a either a unique two semester pre-calculus course (Math 29A and 29B) or a year of calculus (Math 30 and 31), which includes enrichment workshops ("math labs") during the 2015-2016 academic year (in addition to major and general education courses). Name of Applicant How long have you known the applicant What is your relationship to the applicant Please check the most appropriate response: Scholastic Ability Excellent Above Average Average Below Average Unable to Judge Intellectual Potential Initiative Self Discipline Creativity Integrity Social Skills Leadership Persistence -over- Math Honors Program Page 6 4/21/2015
Recommendation Form If you would like to qualify any of the ratings, or would like to make additional comments, please use the space below or attach a separate sheet of paper. We would appreciate any candid comments you may have concerning this applicant s qualifications, personal attributes, and potential for success in science, engineering, or math. Name Printed Signature Title Date Day time Phone # Recommendations should be completed and submitted to the attention of: LSAMP Math Summer Program Science Educational Equity Program California State University, Sacramento 6000 J Street, Sequoia Hall 315 Sacramento, CA 95819-6119 Phone Number: (916) 278-6519 Fax Number: (916) 278-4640 All application materials should be submitted by the priority application due date Friday, June 12, 2015. Math Honors Program Page 7 4/21/2015
Recommendation Form California State University, Sacramento (Sacramento State), through its Science Educational Equity (SEE) Program, will be offering a Math Honors Program for students eligible to participate in the California State University-Louis Stokes Alliance for Minority Participation Program (CSU-LSAMP) at Sacramento State. CSU-LSAMP is a state-wide program supported by the National Science Foundation (NSF Grant # HRD-1302873) and the CSU Chancellor s Office, which is designed to broaden participation in science, mathematics, engineering and technology (STEM) disciplines. The LSAMP Math Honors Program consisting of a three-week summer session scheduled for August 3 - August 21, 2015, and depending on the student's level of readiness will be followed by a either a unique two semester pre-calculus course (Math 29A and 29B) or a year of calculus (Math 30 and 31), which includes enrichment workshops ("math labs") during the 2015-2016 academic year (in addition to major and general education courses). Name of Applicant How long have you known the applicant What is your relationship to the applicant Please check the most appropriate response: Scholastic Ability Excellent Above Average Average Below Average Unable to Judge Intellectual Potential Initiative Self Discipline Creativity Integrity Social Skills Leadership Persistence -over- Math Honors Program Page 8 4/21/2015
Recommendation Form If you would like to qualify any of the ratings, or would like to make additional comments, please use the space below or attach a separate sheet of paper. We would appreciate any candid comments you may have concerning this applicant s qualifications, personal attributes, and potential for success in science, engineering, or math. Name Printed Signature Title Date Day time Phone # Recommendations should be completed and submitted to the attention of: LSAMP Math Summer Program Science Educational Equity Program California State University, Sacramento 6000 J Street, Sequoia Hall 315 Sacramento, CA 95819-6119 Phone Number: (916) 278-6519 Fax Number: (916) 278-4640 All application materials should be submitted by the priority application due date Friday, June 12, 2015. Math Honors Program Page 9 4/21/2015