DoD Cyber Scholarship Program Student Applications

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DoD Cyber Scholarship Program
RETURNING STUDENT APPLICATION
PLEASE DO NOT RETURN YOUR APPLICATION TO THE ABOVE ADDRESS. APPLICATIONS
SHOULD BE SUBMITTED TO YOUR UNIVERSITY POINT OF CONTACT.

I. APPLICANT INFORMATION - MUST BE SIGNED BY THE STUDENT APPLICANT.
Student Name:
Current Address:

Second Address:

(current residence)

Phone Number
(cell)

Phone Number

(Landline or Permanent):

Student School Email Address:
Alternate Email Address (gmail / yahoo / hotmail, etc….)

ALL CySP APPLICANTS MUST ANSWER ALL QUESTIONS
ACTIVITY/QUESTION
Cumulative GPA / Transcripts Attached

ITEM INCLUDED / ANSWER (Y/N)

GPA
Single

Which degree level are you requesting consideration by the DoD CySP?
This may or may not be your current degree program. You may have a
dual program (Comm College/Undergrad, Undergrad/Grad,
Masters/PhD)

Bachelor’s
Master’s
PhD/Doctorate

Dual

STUDENT
INITIALS

ANTICIPATED FINAL GRADUATION DATE of the degree program(s)
identified above.
Updated Resume (template provided):
Letter of Reference (one):

II. Supplemental Information (Chart)
A. Applicants for the DoD CySP must provide certain information about their academic standing to enable a
review of academic sufficiency by the appropriate National Centers of Academic Excellence in Cybersecurity,
hereinafter referred to as NCAE-Cs. This section contains the required supplemental information
requirements. You MUST provide ALL required information below to receive full consideration. To be deemed
complete you must obtain and attach certain additional materials to this statement. All information and
material that you attach to this statement shall become part of your Application for Federal Employment.
B. Provide complete responses to all information requirements, as applicable to you, and attach the additional
documents required. Sign and date this statement in the area provided.

Beginning in the FALL of Academic Year 2023-2024,
I will enter the following:
Degree Program Name:

C. You must attach one Letter of Reference to this supplemental statement from persons knowledgeable of
your potential for successful learning, as well as your knowledge and ability. At least one of these letters must
be from a current faculty member [or a most current faculty member], and the second letter may be from
either a current or former faculty member, or a current or former employer. Each letter must contain the
name, position or title, telephone number, email address, and institutional or organizational address of the
referee. In addition, you must request that each referee refer to and address the following factors:
a. The relationship of the referee to you. (The referee states whether the information is based on an academic
or employment relationship.)
b. The length of the relationship. (The referee states how long he or she has known you.)
c. An assessment of your potential for academic success and fulfillment of degree requirements. (Advise your
referees that your college or university will base a determination of your academic sufficiency, in part, on
the letters of reference that you submit.)
D. By signing this supplemental statement, I acknowledge that the information given above is true and
correct:
NAME: _________________________________________________________________________________________
SIGNATURE: ___________________________________________________________________Date: _____________________________

OCTOBER 2022

E. OF612:

OPTIONAL APPLICATION FOR FEDERAL EMPLOYMENT
SUPPLEMENTAL STATEMENT OF GENERAL ACADEMIC AND
EMPLOYMENT CONDITIONS
To be considered for the DoD Cyber Scholarship Program (CySP), you must agree to certain academic standards
and conditions of employment. This OF612 supplement describes those conditions. Read this statement
carefully, and indicate your elections, where appropriate. When you understand all of the conditions completely,
and agree with all of them, sign and date the statement, and include it with your Resume and OF612 Supplemental
information.
1) In order to receive financial assistance (a scholarship) or appointment under the DoD Cyber Scholarship
Program, you must be enrolled (or accepted for enrollment) at one of the institutions of higher education
designated by the National Centers of Academic Excellence in Cyber Education (Cyber Defense and Research),
or National Centers of Academic Excellence in Cyber Operations, hereinafter referred to as NCAE-Cs, or
enrolled (or accepted for enrollment) in an institution selected by a NCAE-C as a collaborating partner in the
Cyber Scholarship Program.
2) In order to receive financial assistance (a scholarship) or appointment under the DoD CySP, the NCAE-C at
which you are enrolled (or accepted for enrollment) must submit a successful grant proposal to the DoD to
establish the DoD CySP on their campus.
3) In order to receive financial assistance (a scholarship) or appointment under the DoD CySP, you must be
enrolled (or accepted for enrollment) in a full-time program leading to a 2-year Associates/4-year undergrad,
an undergraduate or master’s degree, or doctoral degree, and pursuing a course of study and/or have a declared
major in one of the scientific, technical or managerial disciplines related to computer and network security,
with a concentration in a cybersecurity function.
a) Cybersecurity encompasses the scientific, technical, and management disciplines required to ensure
computer and network security, including the following functions:
 System/network administration and operations
 Systems security engineering
 Information assurance systems and product acquisition
 Cryptography
 Threat and vulnerability assessment, to include risk management
 Web security
 Operations of computer emergency response teams
 Computer forensics
 Defensive information operations
 Critical information infrastructure assurance
b) Relevant cyber-related academic disciplines, with concentrations in cyber security, would include, but are not
limited to:
Biometrics
Business Management or Administration
Business Process Analysis
Computer Crime Investigations Computer Engineering
Computer Programming
Computer Science
Computer Systems Analysis Cyber Operations
Cybersecurity
Cybersecurity Policy
Database Administration
Data Management

Data Science
Digital and Multimedia Forensics Electrical Engineering
Electronics Engineering
Information Security (Assurance)
Information Systems
Information Technology Acquisition
IT Program/Project Management
Mathematics
Network Management/Operations
Software Engineering
Systems Engineering

4) If you are a community college student, you must maintain an overall 3.0 out of a 4.0 grade point average (GPA),
an undergraduate student, you must maintain an overall 3.2 out of a 4.0 GPA, or a graduate student, you must

OCTOBER 2022

maintain a 3.5 out of 4.0 GPA. (or an analogous rank based on a comparable scale) in order to receive financial
assistance (a scholarship) under the CySP. Failure to maintain these minimum grade point averages
constitutes grounds for immediate termination of financial assistance and your appointment under the CySP.
Additionally, if you fail to complete the degree program satisfactorily or to fulfill the service
commitment upon graduation, you shall be required to reimburse the United States, in whole or in part,
the cost of the financial (scholarship) assistance provided.
5) Except for small achievement awards (not to exceed $6,000 in any academic year), you may not accept
simultaneous remuneration from another scholarship or fellowship to pay for tuition while receiving financial
assistance under the DoD CySP. The DoD CySP is a first-pay, merit scholarship program. Free Application for
Federal Student Aid (FAFSA) or Cost of Attendance does not apply to the DoD CySP. The additional funding may
be used for living expenses, supplies, or other educational costs. If you are in a graduate program, you may
receive a reasonable amount of remuneration for teaching or similar activities as are, in the institution’s opinion,
contributory to your academic progress. Except where state or local law, court or proper administrative order
declares otherwise, the DoD shall assume that the development of students, not service to the academic
institution, will govern the assignment of these activities. Students paid as part of employment to the institution
does not count towards the $6,000 limit (Research Assistant, Campus Ambassador, Peer Tutor, Resident
Assistant, Event Caterer, Campus Tour Guide, Lifeguard, or any other on-campus job open to all students).
Students who receive a salary (paycheck) as part of employment to any non DoD or Federal company or agency
does not factor into the $6,000 limit.
6) In order to receive financial assistance (a scholarship) under the DoD CySP, you must agree to accept a
federal appointment under the authority to employ individuals completing Department of Defense
Scholarship or Fellowship Program, or another hiring authority. You may be appointed under this program as
a GS-5, GS-7, GS-9, or GS-11 based on your qualifications, and the needs and conditions of the appointing defense
component. During your period of service under this appointment, if timing permits, you must accept and
perform intern assignments designed to enhance your academic studies in cybersecurity. These assignments
will be scheduled at times mutually agreeable to you, your school, and the DoD component that appoints you. If
you are are terminated during your internship or period of obligated service you will be required to pay the
scholarship back. If you voluntarily leave the obligated service you will be required to pay the scholarship back.
7) In order to receive financial assistance (a scholarship) under the DoD CySP, you must agree to work for the DoD,
after the award of your degree, as a civilian* employee for one calendar year for each academic year, or partial
year, for which financial assistance (scholarship) is received. *See paragraph 8 for terms of military service,
should you desire this option. This requirement is called “obligated service”. The work you may perform
during an internship DOES NOT COUNT toward satisfaction of your obligated service requirement.
8) Should you desire to enlist or accept a commission to serve on active duty in one of the Military Services , you
must incur a service obligation of a minimum of 4 years on active duty in that Service upon graduation. The
Military Services may establish a service obligation longer than 4 years, depending on the occupational specialty
and type of enlistment or commissioning program selected. The DoD CySP does not have the ability to reduce
your military service obligation should you decide to go that route. The Military Service commitment trumps the
DoD CySP service obligation.
9) In order to receive financial assistance (a scholarship) or appointment under the DoD CySP, you must
agree to be mobile. Upon appointment, you will be required to sign an agreement to accept assignments that
involve travel or changes in duty stations, assignments in different organizations, assignments in different
functional areas, and assignments in different geographic areas, during your internship, if applicable, AND during
your incumbency of any permanent, full-time position to which you are converted on program completion. Your
travel under this agreement, and the travel of all DoD civilian employees, is governed by the Federal Travel
Regulations and the DoD Joint Travel Regulations. These regulations provide for travel benefits, and pay or
reimbursement of your travel expenses, on an incidental, case-by-case basis; it is not possible to specify your
exact entitlement to travel benefits at this time.
10) The DoD does not guarantee that your preferences for agency assignment (or location) under the DoD CySP,
or in a permanent position to which you are subsequently converted, can be honored. Your preferences will
be taken into account, along with all other relevant factors such as: mission, functional, and staffing
requirements; the exigencies of service; the availability of funds; and, any hardships you may demonstrate.
Nonetheless, your agency preferences are important to the department. Therefore, you may specify up to three

OCTOBER 2022

agency preferences below, if you wish. You are not required to complete these preference selections. You may
specify city and state of preference, if known as well. For information on DoD Agencies, you may view the
following web site which contains the Office of the Secretary of Defense, Defense Agencies and DoD Field
Activities, Organization and Functions Guidebook:
http://www.defense.gov/about/
11) In order to receive financial assistance (a scholarship) under the DoD CySP, you must agree to reimburse the
United States should you voluntarily terminate your employment with the DoD before the end of your period of
obligated service. (See also item 7 above.) Should you terminate your appointment u n d e r the CySP,
decline or refuse to honor your commitment to accept permanent employment, or, voluntarily terminate
permanent employment before you have fulfilled your period of obligated service, you must reimburse
the United States, in whole or in part, the cost of the financial (scholarship) assistance provided to you. An
obligation to reimburse under this condition of employment is for all purposes considered to be a debt owed
to the United States.
12) In order to receive financial assistance (a scholarship) or an appointment under the DoD CySP, you must
agree to sign certain forms authorizing a background investigation to permit the appointing agency to
make a determination as to your suitability for federal employment.
13) You will be required to obtain and maintain eligibility for a security clearance in order to receive financial
(scholarship) assistance or an appointment under the DoD CySP.
You may be required to undergo
certain tests, including drug and polygraph tests, to obtain and maintain a clearance. Before you may be awarded
a scholarship or hired by DoD, you will be required to complete certain forms to initiate the security clearance
process. Some of these forms will require that you reveal extensive information about your background, such as
potentially sensitive information about your financial circumstances and any arrests and/or convictions for
offenses of any kind. You must agree to all of these conditions of employment and you must complete these
forms as a condition of financial assistance and appointment.
Current web pages from the Office of Personnel Management (OPM) provided below. This is provided for your review
and consideration in determining whether you will be eligible for a security clearance. This may not be all inclusive,
however, it is highly recommended that you review and understand the requirements prior to signing up to
participate in the DoD CySP. https://nbib.opm.gov/e-qip-background-investigations/

By signing this OF612 Supplemental Statement of General Academic and
Employment Conditions, I acknowledge that I have read, understand, and agree to
all of its conditions, to include the Security Clearance Requirements:

Name:

Signature:

Date:

LAST NAME ONLY:
OCTOBER 2022