Application (Revised)

National Aeronautics and Space Administration Application System

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http://nsgf.local/apps/?pk=wish&user_nbr=blank

Please Note: This is a sample application for viewing purposes only. The "Submit Application", "Save for Later" and
"Logout" buttons do not do anything. To apply to this program please visit the application "New User Registration" page
and register with the application system.
Women in STEM High School Aerospace Scholars
Application Due Date: Monday - February 28, 2011
Submit Application
Save for Later
Logout
Please save your work as you go as your session will time out after 60 minutes of inactivity.
Applications Due: Monday - February 28, 2011
Frequently Asked Questions
Personal Information
First Name:
Middle Name:
Last Name:
Preferred Name:
e-mail: [email protected]
Home Address:
,
Home Phone: (
Text messaging:

)

-

Send application updates via text message
Both cell phone and cell phone provider are required for this option. If your cell phone provider is not listed then this system does not
support the texting option for your cell phone provider.

Cell Phone: (

)

-

Required only for texting option

Required only for texting option

Cell Phone Provider:

, 19

Birthdate:
Parent/Legal Guardian:
Parent/Legal Guardian's Work or Cell Phone: (

)-

-

Parent/Legal Guardian's email address
Email confirm
Are you a US Citizen?

Yes

No

Are you a female student?

Yes

No

Are you a high school junior?

Yes

No

School Information
School Name:
School Address:
,
Guidance Counselor Name:
Guidance Counselor email:
Home School:

I am home schooled

GPA:

out of

Class Rank:

out of

CTE: Are you now enrolled or have you completed career and technology education (CTE) coursework related to a science, technology,
engineering, or mathematics occupational competency?
Yes
No
If you answered yes above, please list the CTE courses that you have taken.

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National Aeronautics and Space Administration Application System

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http://nsgf.local/apps/?pk=wish&user_nbr=blank

Transcript: Please upload a current transcript from your High School. If you do not have a PDF conversion tool you can use one of these free
on-line PDF converters PDF Online - Neevia Technology
To ensure that your transcripts may be properly included in your application file, please ensure that they are not protected via
encryption, a password, a signed certificate or in any other manner.
Please completely mark-out your social security number if it appears on your transcript.
(PDF format only)
Post High-School Education: What are your higher education plans after high school graduation? Please check all that apply.
No Plans
Career and/or Technical School
Community College
Four-year College
Graduate school
Recommendation Letter As part of your application packet you are required to provide a letter of recommendation from a teacher, school administrator, or
counselor who can attest to your academic qualifications.
Name:
Title:
Institution:
Phone:
email:
email confirm:
Once you have submitted your application, the system will email the person with instructions on how to submit an on-line letter of
recommendation on your behalf. Please inform them that they will be receiving an email from applications@localhost with these
instructions.
Note: It is the responsibility of the student to follow up with the person who is providing a letter of recommendation to ensure the
recommendation is submitted electronically by the Monday - February 28, 2011 deadline.
Legislative District Information Look up your U.S. Representative
Representative's Name:
District:
Other Information Explain why you wish to participate in the WISH project and why you would be successful. Describe personal characteristics,
strengths and interests to support your explanation.
(750 words or less)

Please describe your career aspirations, extra-curricular activities, work experiences, volunteer work, honors, awards and hobbies.
(750 words or less)

How did you hear about the WISH project?

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http://nsgf.local/apps/?pk=wish&user_nbr=blank

Optional Information Students are strongly encouraged to provide the information requested below. This information is collected for federal reporting
purposes only and is not accessible to the project's selection panel.
Ethnicity:
Race:
Person With Disability:
Student Certification

Yes

No

By applying to the WISH project, you are acknowledging the following:
The responses submitted on this application are true, complete, and correct to the best of my knowledge and belief and
are made in good faith. I understand that a knowing and willful false statement on this application will forfeit my
participation in the WISH project.
Personal responsibility for submission of required online assignments and a final project; adhering to the due dates
posted on the website.
All assignments, including the final project, will be completed using the honor system.
Online assignments will be graded by certified teachers using the rubric(s) posted on the website.
Students will be selected for the summer workshop experience based on the following criterion: completion of application
by the deadline of Monday - February 28, 2011, Essay content, Recommendation letter, GPA/RANK, Completion,
timeliness, and academic performance of all online assignments and the final project.
Efforts will also be made to ensure geographic diversity of selected applicants.
Should I be selected for the summer experience, I will be available July 31-August 5, 2011.
If I participate, NASA representatives will contact me up to six years beyond my participation to learn of my college and
career plans. This will be done via email, mail or phone. This information will be used to assist NASA in determining the
impact of the project. Furthermore I understand my personally identifiable information will not be disclosed.

Parent/Legal Guardian Certification

By your child applying to the WISH project, you are acknowledging the following:
I give permission for my student to submit the WISH application and participate in the on-line community, and summer
experience if selected.
The submission of this application is voluntary and I have reviewed and approved my student’s responses.
The responses submitted on this application are true, complete, and correct to the best of my knowledge and belief and
are made in good faith. I understand that a knowing and willful false statement on this application will forfeit my child’s
participation in the WISH project.
My child is personally responsible for submission of required online assignments and final project; adhering to the due
dates posted on the website.
All assignments, including the final project, will be completed using the honor system.
Online assignments will be graded by certified teachers using the rubric(s) posted on the website.
Students will be selected for the summer workshop experience based on the following criterion: completion of application
by the deadline of Monday - February 28, 2011, Essay content, Recommendation letter, GPA/RANK, Completion,
timeliness, and academic performance of all online assignments and the final project.
Efforts will also be made to ensure geographic diversity of selected applicants.
Should my child be selected for the summer experience, student will be available July 31-August 5, 2011.
If my student participates, NASA representatives will contact my student up to six years beyond her participation to learn
of her college and career plans. This will be done via email, mail or phone. This information will be used to assist NASA
in determining the impact of the project. Furthermore I understand her personally identifiable information will not be
disclosed.
An email will be sent to the student and parent/legal guardian’s emails confirming the student’s application.

Please save your work as you go as your session will time out after 60 minutes of inactivity.
Submit Application
Save for Later
Logout
Application Due Date: Monday - February 28, 2011

Please Note: This is a sample application for viewing purposes only. The "Submit Application", "Save for Later" and
"Logout" buttons do not do anything. To apply to this program please visit the application "New User Registration" page
and register with the application system.
Return to the WISH Website

This system is hosted and maintained by the National Space Grant Foundation.
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© 2011 National Space Grant Foundation

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