Agilent Scholar Information Form

Form
Agilent Scholar Information Form

***All fields must be complete for document to be accepted ***
Name

First NameLast Name
Email
example@example.com
D#
Classification ( freshman, sophomore, etc.)
Major
GPA
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number
Please enter a valid phone number.
Do you need tuition support?

YesNo
Do you need housing support?

YesNo
Are you considered an instate or out of state student?
Have you ever been an Agilent Scholar?

YesNo
Would you like to have an Agilent Mentor?

YesNo
Agilent Scholar Criteria
- Meet SAP gpa minimum (undergrad
- Create a short bio and bio picture.
- Send all required information by deadline given
Agilent Scholar Requirement

·      Attend all Agilent required visits (dates will be given at later date)

·      Attend all required on campus events per request.

·      Complete all internship requirements.

·      Attend all Agilent scholar group and one on one meetings unless have an approved excuse from the PI.

·      Maintain the SAP required GPA

·      Maintain satisfactory attendance in all classes and lab.
Sign if agree to the Requirement

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Short Biography (Required for application acceptance)

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