KMK NBEO Parts I & II Grants
Application Form
Name
*
First Name
*
Last Name
*
Address
*
Street Address Line 2
Street Address
*
City
*
State
*
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Phone Number
*
-
Phone Number
Email
*
example@example.com
Ethnicity
*
American Indian or Alaskan Native
Hispanic/Latino
Caucasian
Asian
AfricanAmerican
Other
Current GPA:
*
Previous CSTEP Student at SUNY?
*
Yes
No
If yes, what year were you in the program
Year
Please attach a brief essay (no more 500 words) describing how you will contribute (or have been contributing) to the diversity of our college community, including having to overcome a disadvantage or other impediment to success in higher education. Please discuss why you feel you are deserving of this grant. Include any support you’ve provided to other minority students, such as visiting CSTEP students from high schools or undergraduate institutions, your support of our CSTEP programs here at SUNY and anything you’ve done to contribute to the mission of SUNY Irises.
Essay Attachment
*
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