Fillable SEEDSScholarApplication Spring 2016

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SEEDSScholarApplication Spring 2016

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The SEEDSScholarApplication Spring 2016 form is 4 pages long and contains:

  • 1 signature
  • 6 check-boxes
  • 60 other fields

Country of origin: US
File type: PDF

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The “SEEDS” Scholars Program (STEM Engagement for the Enrichment of Diverse Students)
is designed to increase the number of Hispanic and underrepresented students pursuing
future graduate degrees by providing a firm foundation of advanced knowledge and skills in
STEM-related fields (science, technology, engineering, math), beginning in the first two years
of college. Students from all backgrounds who have STEM or non-STEM majors are welcome
to apply. Current SEEDS Scholars have a variety of majors including nutrition, business,
accounting, biology, chemistry, engineering, math, computer science, liberal arts, social
sciences, behavioral sciences, and the humanities.
APPLICATION INSTRUCTIONS
1. Review the SEEDS website www.sdmesa.edu/seeds to learn more about the SEEDS
Scholars Program at San Diego Mesa College.
2. Read and follow all instructions carefully. Contact Dr. Leticia P. López (email:
llopez@sdccd.edu, office phone: 619-388-2353) with questions.
3. Send completed applications to the SEEDS Selection Committee.
via email (preferred): llopez@sdccd.edu (include SEEDS Application in the subject line)
via mail: Dr. Leticia P. López, 7250 Mesa College Drive, G-248, San Diego, CA 92111
4. Applications are due by 11:59 p.m. on Friday, May 6, 2016.
APPLICATION CHECKLIST
1. Application. Completed, signed, and delivered by 11:59 p.m. on Friday, May 6, 2016. We
frequently communicate with applicants by e-mail. Provide a reliable e-mail account that you
check and use often. Submit the application as a .pdf document.
2. Question Responses. Thoroughly respond to all four questions (shown on page 3 of this
application) and submit a .pdf or .docx document.
3. Transcripts. Attach unofficial copies of your transcripts from your high school, or if you
are a Mesa College student, from Reg-E of current and past classes taken at Mesa College or
at other colleges. Submit your transcript(s) as .jpg, .png, or .pdf documents.
4. Resume (optional). Attach a current resume.
Funding for SEEDS is provided by the National Institute of Food and Agriculture, United
States Department of Agriculture.
2
Today’s Date: _________________________
STUDENT INFORMATION
Name: _____________________________________ Home Phone: ___________________
Address 1: __________________________________ Cell Phone: _____________________
Address 2: __________________________________ High School: ____________________
Email: _____________________________________________________________________
High School GPA: _________ High School Graduation Date: __________________________
Are you currently a Mesa College student? Yes No
If Yes, what is your GPA? ________________ If Yes, what is your CSID? __________
Gender: Male Female Birth Date: _______________________
Are you Hispanic or Latino? Yes No
What is your ethnic/racial background? ___________________________________________
Are you the first in your family to enroll in college? Yes No
Are you disabled? Yes No
Are you an EOPS or EOPS-eligible student? Yes No
Have you applied for financial aid? Yes No
If Yes, what is your financial aid award? _____________________________________
_____________________________________________________________________
_____________________________________________________________________
What is your mother’s/guardian’s highest level of education?
High school or lower Undergraduate degree Graduate degree
What is your mother’s/guardian’s occupation? ______________________________________
What is your father’s/guardian’s highest level of education?
High school or lower Undergraduate degree Graduate degree
What is your father’s/guardian’s occupation? _______________________________________
3
List your extracurricular and volunteer activities: ___________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Are you presently employed? Yes No
If Yes, where do you work and how many hours per week do you work?
_____________________________________________________________________
How did you hear about the SEEDS Scholars Program? ______________________________
___________________________________________________________________________
QUESTIONS
Thoroughly respond to all questions and submit a .pdf or .docx document. Your response to
each question must be between 200 and 350 words.
Question 1. Why would you like to join the SEEDS Scholars Program?
Question 2. How you have demonstrated leadership ability in your school, work, or
community?
Question 3. What is your interest in science?
Question 4. What is your experience in building relationships with people from
different cultural backgrounds?
REFERENCES
Identify three people outside of your family that know you well, and who could speak about
your educational skills, your work in the community, or your passion for environmental
issues. At least one of your references must be a teacher/professor or school counselor.
Reference 1 Name: ___________________________________________________________
Email address: _________________________________________________________
Phone number: ________________________________________________________
How do you know this reference? __________________________________________
How long have you known this reference? ___________________________________
4
Reference 2 Name: ___________________________________________________________
Email address: _________________________________________________________
Phone number: ________________________________________________________
How do you know this reference? __________________________________________
How long have you known this reference? ___________________________________
Reference 3 Name: ___________________________________________________________
Email address: _________________________________________________________
Phone number: ________________________________________________________
How do you know this reference? __________________________________________
How long have you known this reference? ___________________________________
CERTIFICATION
I certify that all the information provided in this application is accurate and complete, to the
best of my knowledge. The SEEDS Scholars Program has my permission to contact the
admissions or registrar office for student record verifications. If selected into the SD Mesa
College SEEDS Scholars Program, I understand that providing false information is grounds for
dismissal from the program.
Student Name (printed): _______________________________________________________
Signature: __________________________________________________________________
Date: ______________________
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SEEDSScholarApplication Spring 2016

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Completed 18 February 2020

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