AMERICAN SOCIETY OF CIVIL ENGINEERS

NATIONAL CAPITAL SECTION SCHOLARSHIP TRUST

SCHOLARSHIP APPLICATION Date: _____________

NAME: _____________________________________________________________

Last First Middle

Personal Data:

CITIZENSHIP U.S.A. _____ OTHER: ___________________________________

Name of Country

ADDRESSES:

Home _______________________________________________________________

___________________________________________ Phone ___________________

University ____________________________________________________________

___________________________________________ Phone ___________________

PARENTS/GUARDIANS: ______________________________________________

ADDRESS: Home ___; Other ____________________________________________

_____________________________________________________________________

Publicity Data (for use if award made):

HOMETOWN NEWSPAPER

_______________________ _______________________ _____________________

Name Contact Phone/Fax

HOMETOWN TV/RADIO STATIONS

_______________________ _______________________ _____________________

Name Contact Phone/Fax

_______________________ _______________________ _____________________

_______________________ _______________________ _____________________

Eligibility:

COLLEGE/UNIVERSITY RECORD (Attach transcripts)

College/ Full Current Years Hours GPA

Location Time? Standing Attended Completed (A=4)

_________________ ________ ___________ _________ ___________ ______

_________________ ________ ___________ _________ ___________ ______

_________________ ________ ___________ _________ ___________ ______

Special awards or honors: ______________________________________________

ASCE PARTICIPATION

Student Chapter (current): ________________________________________________

(previous): _______________________________________________

Describe activities/positions held: _________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

Written Recommendation:

Attach a written recommendation from ASCE Faculty Advisor and Department Chairman at current university and have one of these officials complete the certification below.

Written Application:

On a separate page, in less than 500 words, explain why you believe you should receive an ASCE scholarship. As a minimum, provide details of:

· your professional goals

· academic and other achievements and honors

· work experience

· special interests

· community service

Statement should be typed or legibly handwritten, dated and signed.

Application submitted:

______________________________________________________________________

Signature of Applicant Date

Certification:

Verification has been made of the applicant's grade point average, standing as full-time sophomore or junior year student, active membership in ASCE Student Chapter or Club, and citizenship.

______________________________________________________________________

ASCE Faculty Advisor or Dept. Chairman Date

Attachments

· Application

· Recommendation

· Transcripts

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