College Scholars Program Application

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The College Scholars Program provides mentorship, resources and services to currently enrolled college students. There may also be opportuntitiesHouston for employment with STEM Bridges other programs. Please complete the application and we will contact you to set up an interview. All Services provided by STEM Bridges Houston College Scholars Program are free.

Email *

Last Name *

First Name *

What is your email address? *

Date of Birth *

YYYY

What college or university do you attend? *

What is current level in school *

How many college credits have you completed? *

What is your Major? *

What is your Minor? (Put n/a, if you do not have a minor) *

Anticipated Graduation Date? *

YYYY

What is your educational goal? *

What is your career goal? *

I am interested in the following services: (select all that apply) *

Class selection and advising

Internships

Scholarships and Financial Aid

Mentorships

Tutorials

Required

T-Shirt Size? *

XXL

Name of Emergency Contact *

Emergency Contact Phone Number *

I understand that my signature authorizes STEM BRIDGES Houston representatives and/or the news media to photograph, videotape, audiotape, duplicate and transfer to any present or future technology their images while they are scholars, featured subjects or participants in STEM BRIDGES Houston programs. Authorized agents and news media may use the photographs, videotapes, and audiotapes as appropriate to promote the STEM BRIDGES Houston and related programs. No compensation will be paid for this use. I certify that the information reported on this application is true, complete, and accurate to the best of my knowledge. *

Yes

I understand that my signature means that I will actively communicate with and provide updates to STEM Bridges Houston staff or representatives while enrolled in college, in reference to information about course completion, grades, etc. *

Yes

Electronic Signature *

Submit

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