1 Name: Citrus ID #____________________________ Last First Phone Number: _______________________ Preferred E-mail Address: ____ __ A complete application must have the following: Completed and signed STEM 3 /Project Raise (CSUF) Application Form Unofficial transcripts for all colleges you’ve attended Student Educational Plan (SEP) A print out of your current Financial Aid Award letter (find this on Wingspan) I am applying for: □ STEM 3 (Cal Poly Pomona) □ Project RAISE (CSUF) □ Both Please read, mark the appropriate boxes to indicate your understanding, and sign the application: □ I hereby certify to the best of my knowledge that all information submitted as a part of this application is complete and correct. I understand that failure to disclose accurate information is grounds for immediate termination from this program. □ I understand that as a member of STEM 3 and/or Project RAISE (CSUF) my name, program status, and other educational information may be shared with the STEM 3 /RAISE teams at Citrus College, Cal Poly Pomona, CSU Fullerton and an independent evaluator. □ I understand that to remain eligible for the STEM 3, and/or Project RAISE (CSUF) and the benefits that come with participation, I need to meet continuing eligibility requirements including maintaining a current SEP and attending campus STEM events. □ I understand that if at any point I decide I do not wish to transfer to California State Polytechnic University, Pomona or CSUF Fullerton I should immediately notify the appropriate staff at Citrus College. □ I give my permission for my photograph to be used in project related materials. Applicant’s Signature Date Please return your completed application to Monica Hernandez or Dr. Marianne Smith in SS 172
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STEM (Cal Poly Pomona) Project RAISE (CSUF) Bothcitruscollege.edu/stem3/Documents/STEM3Application.pdf · (Cal Poly Pomona) Project RAISE (CSUF) Both Please read, mark the appropriate
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Name: Citrus ID #____________________________ Last First