Please fill in a valid value for all required fields Are you sure you want to leave this form and resume later? You must upload one of the following file types for the selected field: There was an error displaying the form. Please copy and paste the embed code again. Apply Discount You saved with code *Minnesota High Tech Foundation (MHTF) **Scholarship Application* Applicant Data Please use this section to provide information about yourself. Please note that the red asterix * denotes a required field. ------------------------------------------------------------------------ Name* First Name* Last Name* Address 1* Address Line 1 Address Line 2 City State Zip Code Current Status* FR (1st year) SO (2nd year) JR (3rd year) SR (4th year) Students’ status may include college credits received as part of AP credit or PSEO programs Current Campus/ University/ College Name: * What institution will you attend during the 2012 – 2013 School year?* University of Minnesota system Minnesota State Colleges and Universities Minnesota Private Colleges 2012 -2013 Campus/University/College Name: * Current Major:* Current GPA in Major:* Current overall GPA:* Daytime Phone* Please use the format ###-###-#### Email* Gender:* Male Female Race/ Ethnicity Category* American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White More than one race Please select one Are you the first person in your immediate family to attend a post secondary institution?* Yes No Academic Advisor Please use this section to provide information about your academic advisor. ------------------------------------------------------------------------ Academic Advisor: Daytime Phone: Mailing Address: Address Line 1 Address Line 2 City State Zip Code Email Address: Grant / Scholarship History Please use this section to provide history on grants / scholarships. ------------------------------------------------------------------------ Have you received any grants or scholarships for the current academic year? * Yes No List the grant/scholarship sources and their dollar amount Have you been the recipient of a MHTF Scholarship?* Yes No What year were you a recipient of the MHTF scholarship? Have you applied for a previous MHTF Scholarship?* Yes No What year did you previously apply for the MHTF scholarship? Essay Questions Please complete all questions. Write 250 words or less per response. ------------------------------------------------------------------------ Summarize your academic accomplishments in your major program of study. This should focus on coursework or special projects.* Summarize accomplishments in research, community service, teaching or work that relates to your interest in STEM. * How are you paying for college and how will the scholarship enhance your collegiate experience? * Explain your future academic or career goals after completing your undergraduate degree and how will your career path benefit Minnesota?* Please list any other information pertaining to life circumstances, academics, volunteerism, or interests that you would like us to know. * Supporting Documents Please upload the documents outlined below or mail or fax as instructed. ------------------------------------------------------------------------ Two letters of recommendation are required and must be postmarked, emailed or faxed by the application deadline of April 30, 2012. One letter must be from a current professor or academic advisor in the major program of study. Letters of recommendation must include the contact information of the writer. *Letters of recommendation should be submitted directly to MHTF from the student’s reference separately from the application. Two letters are required; additional letters will not be read. * Minnesota High Technology Foundation Scholarship 2470 Highcrest Road Suite 100 Roseville, MN 55113 Email: scholarship@mhta.org Fax: 952.230.4550 Letter of Recommendation 1 Letter of Recommendation 2 Resume Please submit a resume outlining your academic, work, research/or community service involvement. Proof of Unmet need: Please provide a copy of your “Financial Aid Award Letter” (please provide the entire letter received from the Financial Aid Office for the current school year). Informal Transcript: A copy of the student’s transcript should be attached to the application. MHTF will accept informal transcripts. Terms of Agreement:* Yes No I agree to provide additional information if it will assist the organization in evaluating my application. I understand that if I receive a $5,000 scholarship, I must attend the Minnesota Tekne Awards in November 2012 and that if I receive a $10,000 multi-year award I am required to attend the MHTA Spring Conference, spring 2013. I understand that if I am selected a recipient of any scholarship award, my name will be used in various publications to promote the Tekne Awards, MHTA Spring Conference, and the MHTF scholarship program. I give MHTA permission to share my application materials with MHTA member companies for possible consideration for (check all that apply): I give MHTA permission to share my application materials with MHTA member companies for possible consideration for: Internships Mentoring Relationships Job Opportunities Check all that apply Confirmation Page