UM Microelectronics First Year Scholarship Application

First Year ECE Scholarship Application Form

Application Deadline March 1

This form is to be used by high school seniors applying for a First Year ECE Scholarship. If you are a current UMaine student, please use the ECE Scholarship application form.

When you click the submit button on this form, an email copy of your application will be sent to the ECE Department at UMaine. Your submitted information will then be displayed, along with a release that indicates your willingness to grant access to your academic records to the UMaine ECE Department. You must print out the completed form displayed to you, sign it, and send it to the address indicated. The deadline for submitting the electronic form is March 1 for students entering UMaine the following September. The permission form must be received within a week of the electronic deadline.

Please fill in all data fields. Incomplete information may invalidate your application.

Personal information

Last name
First name and middle initial
Today's date (mm/dd/yyyy)
   
  Current (local) address
Street
City
State
Zip
Day phone
Student ID # (if any)
Birth Date (mm/dd/yyyy)
Email address

High school from which you will graduate or have graduated

Name

Address

Graduation date

(mm/yyyy)

Class rank =

out of as of (mm/yyyy)

SAT Score

(verbal) + (math) = (total)

References (science or math teachers, counselor/principal)

Name Position Work telephone number Email address

Academic Honors (national merit sernifinalist, national honor society, honor roll, science award, etc.)

Activities, sports, student organizations (include any offices held)

Most recent employment (summers and during school)

Date Job Began
(mm/dd/yyyy)		 Date Job Ended
(mm/dd/yyyy)

Job Description/Employer