AIChE Chicago Scholarship Application Form

AIChE Chicago Local Section

Scholarship Application Form

Deadline March 1

Link to Electronic version of this form
I. Requirements:

Read and follow the instructions carefully prior to submitting your application. All winners will be notified on or before the 30th of May. If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization and punctuation.
Link to Scholarship Rules
Acknowledgment*

Yes, I have read and understood all requirements and instructions.
II. Personal Data:

Tell us about yourself
Full Name*

First NameMiddle NameLast Name
Birthdate:*

MonthDayYear
Phone No. :*

Area CodePhone Number
E-mail :*
Where the confirmation will be send to
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
III. Academic Information:

Tell us about your education
Status by the upcoming September/Fall Semester*

High School SeniorFreshmanSophomoreJuniorSeniorOther
College/High School Name*
College/High School Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Grade Point Average (e.g. 3.8/4.0)*
List courses taken:

0/300
IV. Why should you be considered for this scholarship?
How did you become interested in Chemical Engineering?

0/300
Honors, other scholarships or awards received, and any other details on your progress, projects, and/or plans that you would like us to know:

0/300
V. Please upload your letter of recommendation or references.
Click to add files (limit 10 MB)

Browse Files

Cancelof
VI. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.

By pressing theSubmit button, you are claiming that all information in this application is complete andcorrect to the best of your knowledge.
E-Signature:*
pdf filled forms should be printed and sumbitted as attachment
AIChE Chicago Local Section is committed to equal opportunity in education and does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

I. Requirements:

II. Personal Data:

III. Academic Information:

IV. Why should you be considered for this scholarship?

V. Please upload your letter of recommendation or references.

VI. Applicant's E-Signature