2007 INSPIRE Internship Application

Interdisciplinary National Science Program

Incorporating Research and Education Experience

2007 INSPIRE Internship Application

The Interdisciplinary National Science Program Incorporating Research and Education Experience (INSPIRE) is designed to motivate underserved and underrepresented students to pursue STEM-related careers.

Program Description:

The INSPIRE internship program is an educational program which will offer current 11^th graders an opportunity to work side-by-side with engineers or scientists during a six-week NASA-related STEM experience.

Applicant Requirements:

• The applicant must be a U.S. citizen and 16 years old by the program start date;

• Attend school within a 50 mile radius of a NASA Center;

• The applicant must have a minimum cumulative GPA of 3.0 on a 4.0 scale;

• If chosen as a finalist, the applicant must be willing to participate in a formal interview as part of the placement process; and

• The applicant must be available to participate in the 6-week internship on a full-time basis.

Applications must be submitted to one of the following NASA Centers. Applicants must live or attend school within a 50 mile radius of the NASA Center they are applying to;

Ames Research Center

Dryden Flight Research Center

Glenn Research Center

Goddard Space Flight Center

Jet Propulsion Laboratory

Johnson Space Center

Kennedy Space Center

Langley Research Center

Marshall Space Flight Center

Stennis Space Center

Visit the following website to learn more about each Center: http://education.nasa.gov/about/nasacenters/

Interdisciplinary National Science Program

Incorporating Research and Education Experience

2007 INSPIRE Internship Application

1. PERSONAL AND BACKGROUND INFORMATION

	Last Name		First Name			MI
U.S. Citizen Yes No Note: If U.S. citizen and born outside of the U.S. or Puerto Rico, you must provide the information requested below and provide documentation prior to your internship start date. Naturalization no. _____________________ Date issued __________ Date expired ____________ Naturalization no. _____________________ Date issued __________ Date expired ____________
MAILING ADDRESS
Street		City		State	Zip
Email Address		Telephone
SCHOOL INFORMATION
Name		City		State	Zip
Street		City		State	Zip
Name of Guidance/Career Counselor		Telephone
School Email Address:

B. ACADEMIC INFORMATION
Current Academic Level (Fall 2006 – Spring 2007)
Junior
Cumulative GPA out of 4.0 (unweighted) (Eligibility minimum is 3.0)	Expected Graduation Date

TRANSCRIPT

Please attach your current transcript. Transcripts must include final grades for courses through the 2006 Fall academic semester. Photocopying your original transcript for application is acceptable. Unofficial school photocopies are also acceptable. Handwritten report cards are unacceptable. If the transcript does not include current course grades, attach your current report card to your transcript.

If your school is sending your transcript separately, please check .

C. SPECIALIZED SKILL AREAS

Desktop Publishing, i.e., Pagemaker Database, i.e., SQL, MS Access Internet Browser, i.e., Netscape

Webpage Design, i.e., HTML Computer graphics, i.e., Adobe Programming, i.e., Java, C++

Operating System (Linux, Unix) Other _________________________

D. PLACEMENT INFORMATION

Please check the field of study in which you would like to intern. If choosing more than one discipline, indicate order of preference by numbering 1 through 3, with 1 being your first choice. Final student placement is determined by the mentor’s summer assignment request.

____Aerospace/Aeronautics Eng ____Life Science

____Astrophysics ____Materials Eng

____Biological Science ____Mathematics

____Biomedical ____Metallurgy

____Chemical Eng ____Mechanical Eng

____Chemistry ____Physical Science

____Computer Eng/Science ____Physics

____Electronics/Electrical Eng ____Space Science

____Environmental Eng/Science ____Structural Eng

____Industrial Eng ____Systems Eng

____Integration Engineering ____Other (be specific)_____________________________

E. Have you previously participated in a NASA program? Yes No (If no, skip to next question) If yes, please write the name of the program you participated in, the Center/School affiliated with the program and year of participation.

Program Name ___________________________________________

Center/School Name ______________________________________

Year(s) Participated ____________________________

F. PERSONAL ESSAY

Your personal essay is an opportunity to describe your career goals, explain your special talents and skills, and tell why you wish to participate in this program. The essay must be typed on standard-sized paper (8 ½” x 11”) and be signed and dated by you, the applicant. The essay should have no more than 300 words. Submit this essay as a part of the complete INSPIRE Program Application Package.

Your essay must address the following points: (1) what you would like to achieve during your internship, (2) how both you and NASA will benefit from having you as an intern; and (3) interesting facts about yourself that you would like to share as it relates to being considered for a summer internship position (leadership, extracurricular activities, hobbies, special interest, volunteer work, teamwork, past work experience or special projects, etc.).

G. CERTIFICATION AND AUTHORIZATION: (Applicant and parent must sign below to be eligible. Unsigned applications will not be considered).

I affirm that all of the information on this application is true and complete to the best of my knowledge. I certify that I am a U.S. citizen and meet all eligibility requirements as specified in the internship requirements. I understand that application materials become the property of NASA and cannot be returned. I hereby authorize NASA to utilize information about my application and my likeness for public relations purposes, publicity or other educational opportunities.

I also understand that I must participate for the full duration of the internship and failure to do so or abide by the Center’s program policies and requirements, safety and security procedures and completion of required program forms will result in the immediate termination of my internship.

Student Signature __________________________________________________ Date

Parent Signature __________________________________________________ Date

PARENT/GUARDIAN PERMISSION FORM

I understand that _____________________________________________________ is applying for a position in Student’s Name (please print)

the INSPIRE Tier 2B Program which is conducted for 6-weeks during the summer at a NASA facility.

As a part of the application process, I certify that:

• I grant permission for two teachers selected by my son/daughter to complete the Teacher Recommendation Forms.

• I am aware that the Teacher Recommendation Forms will be used as a selection factor for the INSPIRE Program.

• Permission is fully granted for school officials to report achievement and aptitude tests scores.

• I approve the release of my child’s school transcript; and understand that the information gathered will be maintained in confidence.

If selected for the above-mentioned program, I certify by my signature below, that:

• I give permission for my son/daughter to participate in the INSPIRE Program and all program related activities;

• I commit to ensuring my child’s participation for the entire duration of the program (In the event he/she cannot fulfill this commitment, I understand that his/her position as an INSPIRE participant may be terminated immediately);

• I authorize NASA to use any photographs of my son/daughter taken during their INSPIRE Program participation for promotion activities (i.e., web site, newsletter, and promotion materials); and

• I authorize the NASA staff to release my child’s name and address to educational organizations so he/she can be provided with current information on scholarships, other educational programs, college financial aid information, and to enable NASA and its contactors to track and monitor the progress of the INSPIRE program participants.

Emergency Contact:

( ) ( )

Relationship Telephone No. Mobile No.

Parent’s/Guardian’s Signature of Consent Date

Teacher Recommendation - 1 - Science, Mathematics, or Computer Science -
Student’s Name:
Teacher’s Name/Position/Discipline:
Name of School:
How long have you known the student? In what capacity?
Please rate the student in the following areas.
1. Ability to follow rules and directions Always follows Sometimes follows Seldom follows Never follows		2. Accepts responsibility Always accepts responsibility Usually accepts responsibility Sometimes irresponsible Often irresponsible			3. Leadership ability Strong leadership ability Sometimes exhibits leadership Seldom exhibits leadership Always follows others
4. Initiative/Independence Seeks extra tasks Prepares assigned tasks Needs occasional reminders Needs constant reminding Seldom shows initiative		5. Ability to work well with others Always works well Sometimes works well Seldom works well Does not work well			6. Oral communication skills Very articulate Articulate Somewhat articulate Difficulty in articulation Inarticulate
7. Written Communication Excellent writing skills Good writing skills Average writing skills Poor writing skills	8. Level of interest Exhibits high interest Often interested Seldom interested Lacks interest			9. Motivation Highly self-motivated Sometimes motivated Seldom motivated Lacks motivation		10. Maturity Always exhibits maturity Sometimes exhibits maturity Seldom exhibits maturity Immature
Identify the strengths and skills that will most promote this student’s success in our Program: (check all that apply)
Oral Communication Leadership Skills Written Communication Career Awareness				Time Management Interpersonal Skills Research Technique Computer/Technology
Overall Recommendation for the Program Very Highly Recommended (top 5%) Highly Recommended (top 10%) Recommended Recommended with reservations Not Recommended		Teacher Comments:
Signature:_________________________________________________________________						Date:___________________
May we contact you for additional information?	Yes No		Telephone No. (_____)_____________________			E-mail:_________________
This form should be returned as part of the student’s application package

Note: Two recommendations are required using the forms provided. The recommendations must be from the applicant’s teacher of science, math, or computer science. Please have the teacher return the recommendation to the student in a sealed envelope with the teacher’s signature written across the seal.

Teacher Recommendation - 2 - Science, Mathematics, or Computer Science -
Student’s Name:
Teacher’s Name/Position/Discipline:
Name of School:
How long have you known the student? In what capacity?
Please rate the student in the following areas.
1. Ability to follow rules and directions Always follows Sometimes follows Seldom follows Never follows		2. Accepts responsibility Always accepts responsibility Usually accepts responsibility Sometimes irresponsible Often irresponsible			3. Leadership ability Strong leadership ability Sometimes exhibits leadership Seldom exhibits leadership Always follows others
4. Initiative/Independence Seeks extra tasks Prepares assigned tasks Needs occasional reminders Needs constant reminding Seldom shows initiative		5. Ability to work well with others Always works well Sometimes works well Seldom works well Does not work well			6. Oral communication skills Very articulate Articulate Somewhat articulate Difficulty in articulation Inarticulate
7. Written Communication Excellent writing skills Good writing skills Average writing skills Poor writing skills	8. Level of interest Exhibits high interest Often interested Seldom interested Lacks interest			9. Motivation Highly self-motivated Sometimes motivated Seldom motivated Lacks motivation		10. Maturity Always exhibits maturity Sometimes exhibits maturity Seldom exhibits maturity Immature
Identify the strengths and skills that will most promote this student’s success in our Program: (check all that apply)
Oral Communication Leadership Skills Written Communication Career Awareness				Time Management Interpersonal Skills Research Technique Computer/Technology
Overall Recommendation for the Program Very Highly Recommended (top 5%) Highly Recommended (top 10%) Recommended Recommended with reservations Not Recommended		Teacher Comments:
Signature:_________________________________________________________________						Date:___________________
May we contact you for additional information?	Yes No		Telephone No. (_____)_____________________			E-mail:_________________
This form should be returned as part of the student’s application package

Note: Two recommendations are required using the forms provided. The recommendations must be from the applicant’s teacher of science, math, or computer science. Please have the teacher return the recommendation to the student in a sealed envelope with the teacher’s signature written across the seal.

APPLICATION PACKAGE INSTRUCTIONS

Before submitting this application, you should read it thoroughly. Special attention should be given to eligibility requirements, dates, and deadlines. Be sure that you have supplied all information and materials requested. You are encouraged to keep a copy of your completed application package, as we are unable to return any application materials submitted for the program.

A completed INSPIRE application package includes forms and documentation for the following eight (8) areas:

___ Personal/Background Information

___ Academic Information

___ Specialized Skill Areas

___ Placement Information

___ Personal Essay (Maximum of 300 words)

___ Certification and Authorization

___ Parental Consent Form

___ 2 Teacher Recommendations

Please also include or have your school mail your transcript. If your school is mailing your transcript separately, please check .

SPECIAL INSTRUCTIONS FOR SUBMISSION OF APPLICATIONS.

1. Materials must be sent by mail and postmarked no later than …

2. Applications will not be processed unless they are complete and all materials have been received.

3. An incomplete application package will not be forwarded to the Selection Committee.

4. There are no provisions for accepting applications by fax or E-mail.

5. Applicants are usually notified of their selection status by the end of April.

6. Assignments are made based upon the information provided in the application and mentor requests.

7. You will be contacted to acknowledge receipt of the application package.

8. If selected, you will receive an information packet confirming your internship and providing instructions for any preparatory work need to be completed and forms to be signed.

Questions related to the INSPIRE Program may be sent by e-mail (please note INSPIRE Program in the subject line) to: [email protected] or by phone at 321.867.8768

Retain these instructions for your information and mail the completed application package, including all required documentation to:

INSPIRE Project Specialist

NASA Center

Address

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