Application Deadline:  April 3, 2006                Notification: May 12, 2006

Please print and complete this application cover sheet and submit along with your application materials. 

Penn State ID Number:

Local address:

Local phone number:
Email:
Major and College (Indicate if this is an Intercollege Research Program) : 

Degree Sought:
Anticipated Date of Completion:
Department Chair:
Thesis Advisor:

Title of Research Project (if known): 

GPA:  

I certify that (initial each):
[Note: If any statement is not initialed, your application will not be considered.]
___ I am a citizen of the United States.
___ I am or will be a full-time graduate student during the academic years 2006-2007.
___ If awarded a PSGC Fellowship, I agree to provide PSGC information about my studies and/or employment on request beyond the term of the award. (This is part of a NASA requirement to track the long range effectiveness of the scholarship program.)