ALFRED P. SLOAN FOUNDATION PROGRAM TO INCREASE THE NUMBER OF
UNDERREPRESENTED MINORITY STUDENTS RECEIVING PH.D.S IN
MATHEMATICS, SCIENCE AND ENGINEERING

STUDENT APPLICATION FOR SLOAN SCHOLARSHIP

To be eligible to apply for a Sloan Scholarship, students must be African American, Hispanic American, or Native American (U.S. citizen or permanent resident only) and be newly accepted into a Ph.D. program in a department or with faculty who have been approved by the Sloan Foundation to be part of the Foundation’s Minority Ph.D. Program.  Upon receipt of all applications from one Department or group of faculty, the Foundation will select students to become Sloan Scholars.  The number of students associated with each Department or group of faculty to be selected as Sloan Scholars will be the number of Scholarships that the Foundation previously told the relevant Department or faculty that the Foundation would make available.

Name 					Social Security Number 

Address 

Telephone 				Email 

Citizenship 				Race/Ethnicity 		 Gender
 or immigration status

Permanent Resident 			Registration # 

MOST RECENT DEGREE

Designation 			Field 				Date 

College/University 

DEPARTMENT OR FACULTY MEMBER in Sloan Ph.D. Program in which or with whom you will work on your Ph.D.:

University 						Department  

Faculty Member, if applicable 

Date of entry into Ph.D. Program 

Enrollment Status:	Full Time 				Part Time	
FINANCIAL COMMITMENTS that you have received from the Department or faculty member named above (e.g., RA, TA, fellowship).

First year

Second year, if known 

Third Year, if known 

After third year, if know 

CONTACT INFORMATION

Expected fall semester or quarter address and telephone number (if different from above):

Telephone 

Name and address of two other people through whom you expect always to be locatable:

1. 

2. 

COMMITMENTS OF SLOAN SCHOLARS

As a Sloan Scholar, you will be expected to provide to the Sloan Foundation: 

___	a report on your academic progress at the end of every quarter/semester; 

___	an annual report every July on the expenditure of funds received from the Sloan Foundation; 

___	current address and telephone number every time these change while you are enrolled in the Ph.D. program; and 

___	information about what position you accept upon graduation or departure from the Ph.D. program.

								
Signature			                            	Date

Any questions related to this application or the Sloan Foundation’s Minority Ph.D. Program should be referred to Deborah Walden, National Action Council for Minorities in Engineering, Inc., 440 Hamilton Avenue, Suite 302; White Plains, NY  10601-1813.  
Telephone: (914) 539-4010; Fax: (914) 539-4032
 dwalden_sloanphd@nacme.org.