Application to CSTEP
The CSTEP Program at Wells College is designed for New York State residents who belong to groups historically underrepresented in scientific, technical, health-related, or licensed professions or who are economically disadvantaged, and who demonstrate interest in, and potential for a CSTEP-targeted profession. Once accepted students must meet ongoing CSTEP requirements.

In order to be eligible for the program you must be:

• A New York state resident (one year or more) who is a U.S. citizen or permanent resident

• Be enrolled full-time as a Wells College student (12 or more credit hours)

• Be historically underrepresented -- African-American, Hispanic/Latino, Native American OR economically disadvantaged by New York State standards
(See NYS Income Eligibility Criteria: http://www.nysed.gov/common/nysed/files/20-21incomecriteria.pdf)

• Intend to pursue a major/career in the Health Sciences, Science, Technology, Engineering, or Math or and/or pursue a career in a related licensed profession
(See list of New York state-licensed professions: http://www.op.nysed.gov/prof/)

• Agree to abide by the requirements of the CSTEP Program at Wells College; see https://www.wells.edu/cstep for more details.

If you have any questions or concerns regarding eligibility please feel free to email Breanna Jones, the CSTEP program's acting director, at bjones@wells.edu or call 315.364.3452.
Email *
Wells ID number: *
First Name *
Last Name *
Middle Initial *
Date of Birth *
MM
/
DD
/
YYYY
Home Address ZIP CODE *
Home Address Number & Street *
Home Address City & State (e.g., Freeville, NY) *
Are you a permanent New York State resident? (You are considered a permanent NYS resident if you have resided in NY for at least one year) *
Your cell phone number for text updates about events and opportunities. *
Gender *
Race/Ethnicity (select all that apply) *
First-Generation Student Status
The question below will help us correctly report your CSTEP eligibility to our funding organization. If NEITHER of your parents or guardians have earned a bachelor's degree, please answer "Yes."

Further clarification. YOU ARE CONSIDERED A FIRST-GENERATION COLLEGE STUDENT IF:
* You live with Parent/Guardian X who DID NOT earn a bachelor's degree, although Parent/Guradian Y, whom you do not live with, earned their bachelor's degree, OR;
*Either of your parents/ guardians attended a 4-year college institution, but did not graduate and earn a 4-year degree, OR;
*Neither of your parents/guardians attended a 4-year college institution, OR;
*Neither of your parents attended college in the United States


Are you a first-generation college student? *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Wells College. Report Abuse
Google Forms