Summer Transportation Institute (STI) Funded by the Federal Highway Administration and the Kentucky Transportation Cabinet July 9 29, 2017 All application packets must be received or postmarked by APRIL 1, 2017. We will not accept application packets postmarked after the deadline. Incomplete application packets will not be accepted. There will be no exceptions to this policy. Please type your responses to the five following prompts on one or more separate pieces of paper. Include your name and the date in the top right corner on each page. 1. List the courses you had for the Fall 2016 and Spring 2017 semesters, as well as the courses you plan to take for Fall 2017. 2. Tell us what you know about the transportation industry and how it influences our daily life and economy. Please cite your source(s) if you refer to online sources for your response. (500 words or less) 3. Describe your occupational objectives, and your plans for achieving those goals. (500 words or less) 4. Tell us something interesting about yourself that you think we should know. (250 words or less) 5. Explain why you would like to attend the STI and what you would like to gain from the experience. (250 words or less) Applicant Information Penmanship is important! First name Middle name Last name Email Street Apt # City State ZIP County Phone Race* *Voluntary and used for federal funding purposes only Are you a current member of 4-H? Yes No 4-H Program County Parent/Guardian Information Personal Information Female Male Birthdate / / Age (by July 9, 2017) Name of the school you attended for the 2016-2017 year: Grade level completed by July 2017: 8 th 9 th Roommate Request Roommate requests are honored whenever possible. However, both friends must request each other. If possible, I would like to share a room with: T-shirt Size: S M L XL 2X Potential roommate s first and last name Home phone Cell phone First Name Last Name Email (see other side)
Teacher Recommendations MUST BE SUBMITTED WITH THE APPLICATION. DO NOT MAIL RECOMMENDATIONS SEPARATELY. Ask your current Science and Math teachers to complete the enclosed recommendation form. Signatures must be original. School Transcript MUST BE SUBMITTED WITH THE APPLICATION. DO NOT MAIL TRANSCRIPT SEPARATELY. Include the most recent, official, updated transcript of all your course work through the Fall 2016 semester and have your Guidance Counselor indicate the following: Current class rank: # out of Cumulative GPA Grading system used other than the 4.0 scale, please explain: Counselor Name Signature Date / / Counselor Email How did you hear about our program? Counselor or Teacher KSU website Friend Church Recruiting Event KSU faculty or staff or student Prior participant in KSU youth programming Program Name(s) Year(s) Attended Parent/Guardian Consent I approve of my son my daughter applying to the KSU Summer Transportation Institute, and understand that not every applicant will receive a scholarship to attend the program. Parent Signature Date / / Applicant Signature Applicant Signature Date / / RETURN TO: Kentucky State University 400 East Main Street Cooperative Extension Building ATTN: Ms. Shawn Moore STI 2017 Frankfort, KY 40601 It is the policy of Kentucky State University not to discriminate against any individual in its educational programs, activities, or employment on the basis of race, color, national origin, sex, disability, veteran status, age, religion, or marital status.
Summer Transportation Institute (STI) RECOMMENDATION FORM Your math teacher must complete this recommendation form. The completed form must be submitted with your application do not mail the recommendation form separately. Application packet must be postmarked by April 1, 2017. STI Applicant: To be completed by Recommender: Teacher First Name: Teacher Last Name: School Name: Position: 1. How long have you known this student and in what context? 2. How would you rate this student on the following characteristics? (place an X in the box of your choice) Academic achievement Maturity Below Average Average Above Average Excellent No Basis For An Opinion Motivation Ability to work in teams Intellectual curiosity Ability to adapt to new situations (see other side)
3. Kentucky State University s Summer Transportation Institute (STI) is a competitive scholarship program that offers participants the chance to explore various forms of transportation and their associated careers. Students should be recommended to attend if you believe they have the aptitude to engage in technological studies and would benefit from this experience. Please explain why you think this student would be an excellent candidate for the STI. Signature Date
Summer Transportation Institute (STI) RECOMMENDATION FORM Your science teacher must complete this recommendation form. The completed form must be submitted with your application do not mail the recommendation form separately. Application packet must be postmarked by April 1, 2017. STI Applicant: To be completed by Recommender: Teacher First Name: Teacher Last Name: School Name: Position: 1. How long have you known this student and in what context? 2. How would you rate this student on the following characteristics? (place an X in the box of your choice) Academic achievement Maturity Below Average Average Above Average Excellent No Basis For An Opinion Motivation Ability to work in teams Intellectual curiosity Ability to adapt to new situations (see other side)
4. Kentucky State University s Summer Transportation Institute (STI) is a competitive scholarship program that offers participants the chance to explore various forms of transportation and their associated careers. Students should be recommended to attend if you believe they have the aptitude to engage in technological studies and would benefit from this experience. Please explain why you think this student would be an excellent candidate for the STI. Signature Date