Student Education Grant Application

Associate/Undergraduate/Graduate Degree

The State of Texas Chapter of the Health Physics Society (STC-HPS) announces the availability of its Education Grants. The applicant must plan to begin or be currently performing full-time work toward an associate, undergraduate, or graduate degree in Health Physics or a related field offered by a bona fide program at a Texas Institution of higher education. All applicants must have finished one semester by December of the year applying. Applicant must be a student member in good standing of the STC-HPS. Deadline for receipt of applications and all supporting materials is the last day of May of each year. Award winners will be announced at the subsequent Chapter meeting. The STC-HPS Grant is $1,000, and one award will be made at each degree level.

Degree Program:*

AssociateUndergraduateGraduate

Name*

Address*

Phone*

Email (Optional)

Undergraduate Institution*

Submit copies of all current transcripts including the Fall semester and, if available, the Spring semester.

GPA*

Scores*

SATACTGRE

Upload a copy of your SAT, ACT, or GRE scores.

Math

Verbal

Composite ACT

GRE

Statement of Financial Information

On the STC-HPS Student Education Grant Application: Financial information form (page 2), provide a detailed account of all sources of income and expenses for the period of support September-August. Insufficient data may result in delays in processing your application.

Statement of Personal Goals

Upload a separate one-page statement about your personal career goals including a statement about your intent to enter the field of Health Physics.

Letters of Recommendation

Names of two persons whom you will ask to write letters attesting to your potential for study in Health Physics.

1*

2*

*NOTE: Bachelor students with strong interest in Radiological Health Engineering in the Nuclear Engineering (NE) Department of TAMU can apply for the NEFF-POSTON Scholarship by contacting Dr. Jean Ragusa (Jean.Ragusa@tamu.edu ) of the NE Department. This scholarship was endowed by the Stateof Texas Chapter of the Health Physics Society.

Name*

Where do you live?*

On-campus housingOff-campus housing

With whom do you live?*

If you live with children, how many?

Income*

Rows	$/month
Spouse Working
Summer job/school job
From parents/relatives/guardians
Child support
Savings/investments
Scholarships/grants (list below)
VA benefits (educational and/or disability
TRC or JTPA
Other (list below)
TOTAL

Other Income list

Loans (list)

Rows	$/month
1
2
3
LOANS TOTAL

Expenses*

Rows	$/month
Housing & utilities
Automobile (payments, gas, insurance, etc.)
Food
Child support payments
Other (list below)
EXPENSES TOTAL

Other Expenses list

Additional comments/extenuating circumstances [attach additional page(s) if needed]: