GARDEN STATE S-STEM
APPLICATION
Funded by the National Science Foundation (NSF), the S (Scholarship) STEM Grant provides
additional monies for high achieving, full-time college students to enable them to devote more
time to their studies and complete their degree programs.
NAME: ___________________________________________________________________________
ADDRESS: _________________________________________________________________________
EMAIL & PHONE NUMBER: ___________________________________________________________
ACADEMIC MAJOR: _________________________________________________________________
(Must be STEM Major, although not directed toward Health Science or Health Careers)
COMPLETED CREDITS: ______________________________________________________________
PLANNED GRADUATION DATE: _______________________________________________________
GPA – 3.5 minimum (PLEASE ATTACH TRANSCRIPT): ______________________________________
CITIZENSHIP (CIRCLE ONE): US CITIZEN PERMANENT RESIDENT
ARE YOU PELL ELIGIBLE (IF YES, PLEASE ATTACH DOCUMENTATION)? ________________________
DO YOU PLAN TO OBTAIN A BS/BA DEGREE? ____________________________________________
IF YES, WHAT DO YOU WANT TO MAJOR IN? ____________________________________________
IF YES, HAVE YOU DECIDED ON A COLLEGE? IF YES, NAME IT. _______________________________
RACE/ETHNICITY (CIRCLE ONE): Optional
White Asian African American Hispanic/Latino Pacific Islander
Native American Alaskan Native Other Mixed
SIGNED__________________________________________ DATE ___________________________
REQUIRED:
1) Essay (250 words) describing your career plans and how this scholarship will make a difference to you.
2) Letter of recommendation (one) from an HCCC faculty member.
Submit this page and all required documents in electronic or paper format to:
Dr. Fatma Tat, Chemistry Instructor, STEM Division at ftat@hccc.edu, S-Building Room 605C,
Phone (201) 360-5412.
