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Company Name: _________________________________________________________________________
Contact Name: ___________________________________ Title: __________________________________
Address: _______________________________________________________________________________
City: __________________________________________ State: ___________ Zip: ____________________
Phone Number: ( __________ ) __________ - ____________________
Email Address: __________________________________________________________________________
Scholarship Contribution: $____________________________ Number of Years Renewable: __________
Scholarship Name: _______________________________________________________________________
Scholarship Distribution:
# of Scholarships: __________ for $_______________ each
Branding Opportunity! Scholarship Webpage: As an added benefit, corporate sponsors with scholarship
contributions greater than $10,000 may purchase a Corporate Scholarship web page as part of the SHPE
Scholarship’s website. The corporate webpage will highlight the following: company logo, scholarship
contribution amount, and the pictures of all your scholarship recipients. Additional 2.5% Administration fee
applies. Please click here to see a sample webpage.
Yes, please include a Corporate Scholarship Webpage as part of our corporate scholarship branding package.
Review Method: The SHPE scholarship reviewing committee consists of professional and national leaders within the
organization who review scholarships over a 20 day period. If you would like members of your organization to review
scholarship applications rather than SHPEs scholarship committee, please check the box below.
Yes, I will provide a list of volunteers to review and score applications submitted to this scholarship.
Administration Fee Information: Standard Administration fee is 10% and includes two parameters. Additional 2.5%
Administration Fee per additional parameter. Please select scholarship recipient parameter options below:
Minimum GPA: __________ / 4.0 (Note: If left blank, 2.75 will be applied.)
Preferred Major of Study:
Aeronautical/Aerospace Engineering
Biomedical Engineering
Chemical Engineering
Civil Engineering
Computer Sciences & Engineering
Electrical Engineering
Environmental Engineering
Industrial Engineering
Materials Science & Engineering
Mechanical Engineering
Petroleum Engineering
Other: _____________________________
Society of Hispanic Professional Engineers
13181 Crossroads Prkwy. North, Ste. # 450,
City of Industry, CA 91746-3497
Office Phone: 323-725-3970
Tax ID 72-1549994
2020 -2021 Scholarship Program
Sponsor Commitment Form
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Specific Colleges/Universities (minimum of 5 colleges must be selected for this parameter)
1. ___________________________________
2. ___________________________________
3. ___________________________________
4. ___________________________________
5. ___________________________________
6. ___________________________________
7. ___________________________________
8. ___________________________________
9. ___________________________________
10. ___________________________________
Geographic Location:
Any location
Please note that preferred geographic location will be based on applicant’s school address not home address.
Preferred State: ____________
Preferred SHPE Region (Please see region map below): __________
Citizenship Required: Yes No
Class Status: Freshman Sophomore Junior Senior Master Student Doctoral Student
Standardized Test Score:
Test Type: SAT ACT GRE GMAT Other: __________________________________
Minimum Test Score: __________
Other Parameters as Described Below:
_________________________________________ Month / Day / Year .
Signature Date
click to sign
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