YSU-DEEP-C Scholarship Application

Name *

Date of Birth *

Year

Month

Day

Mailing Address

Address *

City *

State *

State

Zip Code *

Phone *

E-mail *

High School *

Student Agreement

Student Signature *

Student Agreement *

The information provided here is true and accurate to the best of my knowledge. I am willing to provide additional information, if requested.

Parent/Guardian Agreement

Parent/Guardian Signature *

Parent/Guardian Agreement *

The information provided here is true and accurate to the best of my knowledge. I am willing to provide additional information, if requested.

REQUIRED SUPPLEMENTAL APPLICATION MATERIALS

Statement of engineering interest *

Why are you interested in engineering and how can this program help you to reach your personal, academic, and career goals? If you know, tell us about which area of engineering you're interested in and why.
Files must be less than 2 MB.
Allowed file types: pdf doc docx.

List of extracurricular activities and leadership roles at school or in the community *

List your activities in this way: Name, date or date range, brief description.

Current HS transcript listing senior year courses

Please attach a copy of your high school transcript that lists your senior year courses (an unofficial transcript is acceptable). If you are not able to obtain a copy to upload, please request your counselor to send your transcript directly to scbrozina@ysu.edu
Files must be less than 2 MB.
Allowed file types: pdf doc docx.

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