Project SEED 2017 Application: General Information

Name: First   Middle Last*  

If you have an email at school, provide it here: 

Your personal Email:*   

Confirm personal Email:  

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Name of Parent(s) you live with

Provide email addresses for your parent(s)
Parent 1 Email:    

Parent 2 Email:  

Address

City   ST   Zip

Home Phone:    

Other Phone:  

High School Name:

High School City:   ST  Zip

High School Phone:   

Expected Graduation Year    Last school day this spring (MM/DD/YY)

When is your school’s first day in the 2017-2018 academic year. (MM/DD/YY)

Date-Of-Birth (MM/DD/YY)

Gender    Ethnicity (choose most descriptive option)

Are you an Indiana 21st century scholar?    Click for 21st century scholar info

Have you ever been part of MEPI, the Minority Engineering Program of Indianapolis?
If NO, only answer 'no'. If YES, please describe the events participated in and the dates.

Have you ever been enrolled in the NOBCChE's CPA program (College Prepatory Academy)?
If NO, only answer 'no'. If YES, please describe the events participated in and the dates.

Have you ever been enrolled in any of the CLD courses?(Center for Leadership Development)
If NO only answer 'no'. If YES, please describe the courses you took and list the dates.

Have you been part of any summer programs at IUPUI like INDA Nanotechnology, NEST, MEAP Engineering or any others?
If NO, only answer 'no'. If YES, please describe your participation events and dates.

Have you ever participated in the Summer of Service program at any of the IU Health Network hospitals such as University, Methodist, Riley or others?
If NO, only answer 'no'. If YES, please describe your participation events and dates. 

 

Summer Transportation:  How will you get from home to your internship location this summer:

1.  Discuss some of the math and science classes you have taken in school. What are some of the most fascinating things you have learned? 

2.  What are your top 2 career choices?  It is very common for students to change their mind about their future goals after being in college a year or two, but as of now, what are your top career choices? What are some things you hope to accomplish?

3.  How do you think you will benefit from the Project SEED research experience and why do you think the Committee on Project SEED should accept you into this internship program?

4. What are the athletic, extracurricular, community, church, volunteer or paid activities in which you have participated during your high school years?  Help us understand what you do in your free time.  Please limit your answer to 250 words.