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Applicant information
*
Indicates required field
Applicant Name
*
First
Last
Age
*
Grade level for the 2019/20 school year?
*
I identify my gender as:
*
Male
Female
Genderqueer/Non-Binary
I prefer not to disclose
School
*
Parent/Guardian Name
*
First
Last
Relationship to applicant
*
Email
*
Phone Number
*
which scholarship are you applying for?
*
Roy Overstreet Scholarship for Minorities
Bill & Fran Darrow Scholarship for Girls
if applicable, which underrepresented group are you from? (check all that apply)
*
Alaskan Native
Native American
Black/African American
Hispanic
Native Hawaiian/Pacific Islander
Persons With Disabilities
Girl
Other
if other, please explain:
*
Which of the following programs would you like to be considered (click all that apply):
*
Summer Computer Science Workshops for Girls
Summer Camps - 1 week
After-School Program - 1 month
Short Answer
Please answer the following questions in
a few sentences
:
How can you contribute to the mission of YSA?
*
Which of the four research themes of the Youth CAUSE Initiative do you most identify with? Why?
*
Why is diversity important in science or at school?
*
what is the biggest issue in wilmington that science can help solve? How can it be solved?
*
Submission Approval
Required
*
I agree
By selecting the checkbox, I hereby declare that all of the information contained in this application is to the best of my knowledge true and correct. I also allow the Executive Director and Board of Directors of the Young Scientist Academy to review my application in confidence and, if applicable, contact references obtained provided by the applicant, parent and/or guardian. I acknowledge that YSA is an Equal Opportunity Provider and follows all laws of North Carolina.
Signature of Applicant
*
Signature of Parent/Guardian
*
date
*
MM/DD/YYYY
How did you hear about this scholarship?
*
Internet
School Teacher
Social Media
Word of Mouth
Flyer
Other
Submit
Home
DONATE
Code Girls
Programs
Afterschool Science Ambassadors Program (ASAP)
Youth CAUSE Initiative
Homeschool Science
Latinx Science Seminars
Virtual Experiences
About
Scholarships
Apply for a Scholarship