Careers in Engineering for Women (CEW) 2012 Non-residential Summer Program Application Monday, June 11 - Friday, June 15, 2012 At The University of Texas at Austin Please mail the completed application, postmarked on or before February 15, 2012 to: The University of Texas at Austin, Society of Women Engineers 1 University Station C2100 ECJ 1.228 Austin, TX 78712-0284 Please print using blue or black ink or type! Name _________________________________ Date of Birth__________________________________ Name for Nametag _______________________ Email______________________________________ Home Mailing Address __________________________________________________________ City__________________ State_____ Zip _________ Home Phone (____) _______________________ Current Grade (circle one): 6th 7th Adult T-shirt Size (circle one): S M L XL Parent/Guardian Name___________________________ Work/Cell Phone (____) ___________________ School Name _________________________ School Address __________________________________ City ___________________ State _____ Zip _________ School Phone (____) _____________________ What is your citizenship status? (Please circle one): U.S. Citizen Permanent Resident Visa Other Are you Hispanic or Latino? (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.) ___Yes ___ No Please select the racial category or categories which you most closely identify. Check as many as apply. ____ American India or Alaska Native ____ Asian _____ Black or African American _____Native Hawaiian or Other Pacific Islander ______ White Have you attended a CEW program in the past? (Please circle one): Yes No . If yes, you are not eligible to attend again. In order to be considered for CEW, please submit the following in one complete packet in this order. Please be sure to put your name on each page. *optional . CEW application form . A copy of your most recent report card (2011-2012 school year) . *A letter of recommendation from a math, science, or computer teacher, or a school counselor (see below) . Your essay (see below) . *Your scholarship essay (see below) . A self-addressed stamped (9-1/2Ó x 4-1/8Ó) envelope . $5 application processing fee (check or money order) Teacher or School Counselor Recommendation (OPTIONAL): The recommendation letter must be sealed in an envelope and signed on the seal. Ask your teacher or counselor to address the following topics in his/her letter: - StudentŐs academic standing - StudentŐs ability to work with other classmates - StudentŐs maturity & classroom behavior - Why CEW would be a good experience for the student Student Essay Question: Describe a non-living object with moving parts that you think needs improvements. Think of changes you could make so that it will work better. Write one handwritten page (you may use the back if necessary) that addresses the following four topics: 1. Description of the object 2. Description of how it currently works or moves 3. Description of what improvements are needed and why 4. Description of what changes you would make so that it will work better (consider how you would make the changes) Please make sure that your essay is your own work! Hint: Choose an object you are familiar with to write about. Scholarship Application (OPTIONAL): If admitted to CEW, a $250 non-refundable fee is required to participate in the program. If you wish to be considered for a scholarship to waive the $250 fee, please answer the additional essay question below (one page or less) that addresses the following topics: 1. Why are you interested in attending CEW? 2. Please describe any circumstances which would help us understand your financial need. DO NOT SUBMIT THE $250 CEW PROGRAM FEE UNTIL YOU HAVE BEEN ACCEPTED INTO THE CEW PROGRAM. Processing Fee: We carefully review every application we receive, and make sure to notify every applicant of our decision. Therefore, we request a $5 application fee to offset the cost of reviewing applications. Please include a $5 money order or check made payable to: UT Society of Women Engineers Would you like us to waive your application fee? (Please circle one): Yes No If yes, include scholarship essay. Required Signatures: Applicant Signature: ___________________________________________ Date: _____________ Parent/Guardian Signature: ______________________________________ Date: _____________ Note: This application may be downloaded from: http://www.engr.utexas.edu/swe/cew.html For more information email: cew@engr.utexas.edu