Expire Application

Interdisciplinary National Science Program

Incorporating Research and Education Experience

2008 INSPIRE Internship Application

The Interdisciplinary National Science Program Incorporating Research and Education Experience (INSPIRE) is a multi-tiered student pipeline program designed to encourage underrepresented and underserved students throughout the U.S. to pursue science, technology, engineering and mathematics (STEM) education and careers. To be considered, students must be a U.S. citizen, be in the appropriate grade at the start of the program and have at least a 2.5 overall unweighted grade point average (GPA) on a 4.0 scale.

Program Description: INSPIRE’s three tiers provides students in grades 9^th through the freshmen year of college opportunities to immerse themselves in on-line activities, e-learning, distance learning and video teleconferencing featuring NASA’s unique content. These activities provide grade appropriate information, interaction, and experiences to add relevancy to courses being taught and real life experiences. INSPIRE also provides opportunities for NASA to encourage family and community participation through activities that inspire, engage and educate the public in NASA’s Exploration Vision.

In addition to the on-line component, INSPIRE students who achieve a 3.0 GPA will have the opportunity to compete for special NASA/STEM experiences with parent’s permission. It is estimated NASA will select 200 students to participate in each of the following experiences:

For tier 1: 10^th grade “NASA Explorers” students compete for a VIP tour of a NASA center and attend workshops at a NASA center as a reward for their achievement and participation in tier activities. Students and their parent/guardian are selected are awarded transportation, lodging and meals to attend the event.

For tier 2: Rising 11^th grade students compete for the “Collegiate Experience” that provides a two (2) week on-campus residential experience at a selected college/university to be exposed to college life as a way to encourage pursuit of a STEM education and career. This is designed to enhance study skills, and provides contact with other STEM engineers, professors, and university-level students. To help defray transportation expenses, families which live outside a 100 mile radius of the participating academic institution will be provided $500 for transportation. Rising 12^th grade students compete for the “High School Internship” which provides a six-week long paid summer internship at a NASA center. Students gain valuable on-the-job experience by working directly with NASA scientists and engineers. Students are involved in intensive educational experiences after work and during weekends to introduce other STEM fields through tours and presentations. Students take shortened academic courses and work in teams to solve problems and give presentations. For this tier students are provided transportation, lodging and meals.

For tier 3: Rising college freshmen students who have been accepted at a college or university and have declared a STEM major compete for an eight-week ”Collegiate Intern” experience at a NASA field installation during the summer prior to their freshman year of college. This introduces the students to other education-sponsored and employment opportunities offered at the university level.

To learn more about each Center: http://education.nasa.gov/about/nasacenters/

For more about INSPIRE: http://education.nasa.gov/edprograms/stdprograms/INSPIRE_Project.html

Interdisciplinary National Science Program

Incorporating Research and Education Experience

2008 INSPIRE 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. Citizenship Form: _____________________ Identification No: __________ Date issued: ____________ (E.g. Naturalization)
MAILING ADDRESS
Street		City		State	Zip
Email Address		Telephone
SCHOOL INFORMATION
Name		City		State	Zip
Street
Telephone Number
School Email Address:

B. ACADEMIC and OTHER INFORMATION
Current Academic Level At Time Of Application
8th grade 9th grade 10th grade 11th grade 12th grade
Cumulative GPA out of 4.0 (unweighted) (Eligibility minimum is 2.5)	Expected High School Graduation Date:

TRANSCRIPT

Please attach your current official transcript. Transcripts must include final grades for courses through the most current academic term.

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

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 _________________________

CAREER INTEREST INFORMATION

Please check the field of study in which you would like to pursue. If choosing more than one discipline, indicate order of preference by numbering 1 through 3, with 1 being your first choice.

____Aerospace/Aeronautics Eng ____Life Science

____Astrophysics ____Materials Eng

____Biological Science ____Mathematics

____Biomedical ____Metallurgy

____Chemical Eng ____Mechanical Eng

____Chemistry ____Physical Science

____Civil Eng ____Physics

____Computer Eng/Sci ____Space Science

____Electrical/Electronics Eng ____Structural Eng

___ Environmental Eng/Sci ____Systems Eng

____Industrial Engineering ____Other (be specific)_____________________________

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 ____________________________

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 through your expereince, (2) how both you and NASA will benefit from having you as participate; and (3) interesting facts about yourself that you would like to share as it relates to being considered for this program (leadership, extracurricular activities, hobbies, special interest, volunteer work, teamwork, past work experience or special projects, etc.).

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 application. 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.

Please indicate below if you are requesting consideration for the following summer INSPIRE experience:

Parent/Student VIP tour and workshop (Available to rising10^th grade students)

2 week Collegiate Experience (Available to rising 11^th grade students)

6 week High School internship at a NASA field installation (Available to rising 12^th grade students)

8 week internship (Available to students entering their freshman year of college)

Not at this time

Student Signature __________________________________________________ Date

Parent Signature __________________________________________________ Date

PARENT/GUARDIAN PERMISSION FORM

I understand that _____________________________________________________ is applying for participation in NASA’s INSPIRE program Student’s Name (please print)

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

• I grant permission for my son/daughter to select a teacher and one other adult who is most familiar with the student’s capabilities to complete Recommendation Forms.

• I am aware that the 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 supporting my child’s participation for the entire duration of the program

• I understand family involvement is an important component of this program. I commit to accessing and using parent on-line activities and information to encourage and help my child succeed in his/her pursuit of science, technology, engineering, and mathematics education and career.

• 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 filed installations and associated contractors directly involved in this program to implement services and activities and to track and monitor the progress of the INSPIRE program participants.

( ) ( )

Relationship Telephone No. Mobile No.

Parent’s/Guardian’s Signature of Consent Date

Recommendation FORM - 1 NASA INSPIRE PROGRAM
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
Please describe why you are recommending this student for participation in the INSPIRE program:
Overall Recommendation for the Program: Very Highly Recommended Highly Recommended Recommended Recommended with reservations Not Recommended
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. At least one must be from a teacher and the other from any adult who is most familiar with the student’s capabilities. Please return the recommendation to the student in a sealed envelope with your signature written across the seal.

Recommendation - 2 NASA INSPIRE PROGRAM
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
Please describe why you are recommending this student for participation in the INSPIRE program:
Overall Recommendation for the Program: Very Highly Recommended Highly Recommended Recommended Recommended with reservations Not Recommended
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. At least one must be from a teacher and the other from any adult who is most familiar with the student’s capabilities. Please return the recommendation to the student in a sealed envelope with your 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 five sections:

A___ Personal/Background Information

B___ Academic and other Information

C___ Personal Essay (Maximum of 300 words)

D___ Certification and Authorization (Includes of the Parental Permission Form, Recommendations and the Official academic transcript)

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. Students completes and submits on-line the following INSPIRE application sections

   1. Personal/Background Information

   2. Academic and other Information

   3. Personal Essay (Maximum of 300 words)

NOTE: This step can be omitted if you do not have access to a computer. However, on-line submission allows you to check the status of your application.

2. Print complete application (to obtain appropriate signatures and recommendations)

3. Student mails the complete application (sections A thorough D (including the certification and authorization, parental permission, recommendations and official academic transcript)

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

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

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

7. Applicants will be notified of their selection status by mail.

If you need this application in a language other than English, please contact (Will be provided once a support contractor is in place) for a version in the language requested.

Questions related to the INSPIRE Program may be sent by e-mail (please note INSPIRE Program in the subject line) to: (Will be provided once a support contractor is in place) or by phone at (Will be provided once a support contractor is in place)

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

INSPIRE Project Specialist

Address (Will be provided once a support contractor is in place)

3