UM ECE Scholarship Application form

Microelectronics Scholarship Application Form for Current UMaine Students
2010 - 2011 Academic Year

Application Deadline: Monday 22 February 2010

This form is to be used by current UMaine students as part of the application process for the Microelectronics Scholarship Consortium Scholarship. If you are currently a high school student please use the First Year Microelectronics Scholarship Application Form.

Upon completion of this form, click the submit button. In addition to this form, all applicants must submit a resume with a cover letter in electronic format (preferably pdf) to microscholar@eece.maine.edu. The cover letter should address your reasons for applying for the scholarship, coursework you've completed related to the microelectronics industry, previous work experience in the microelectronics industry, and those aspects of the microelectronics industry that are of interest to you. All information you provided will be submitted to the UMaine Microelectronics Consortium Committee. This committee consists of members of the UMaine faculty and representatives of consortium companies. All information will be treated in a confidential manner.

Please fill in all data fields. Incomplete information will 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 #

Birth Date (mm/dd/yyyy)

Email address

High school from which you graduated

Name

State of Residency

Place of birth

References (professors, advisor, department chair, etc.)

Name Department Email

Academic Honors (since entering UMaine - please include scholarships)

Service to the profession, (e.g. 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

Scholastic Record

Semester GPA's
Fall

Spring
Cumulative GPA

First year Major

Sophomore Advisor

Junior

Senior

Top 10% Top 25% Top 50% Bottom 50%

Department Class Rank:
Place an "X" in correct box

Last name
First name and middle initial
Today's date	(mm/dd/yyyy)

Current (local) address
Street
City
State
Zip
Day phone
Student ID #
Birth Date	(mm/dd/yyyy)
Email address

Date Job began (mm/dd/yyyy)	Date Job Ended (mm/dd/yyyy)	Job Description/Employer

Semester GPA's	Fall	Spring	Cumulative GPA
First year			Major
Sophomore			Advisor
Junior
Senior

	Top 10%	Top 25%	Top 50%	Bottom 50%
Department Class Rank: Place an "X" in correct box