HBCU Week x The Future of STEM Scholars Initiative

Page 1

Scholarship Eligibility

	Yes	No
Are you a U.S. citizen or legal permanent resident of the United States?
Are you a high school senior? (Class of 2025)

To be eligible for the scholarship, you must be a U.S. citizen or legal permanent resident of the United States.

To be eligible for the scholarship, you must be a current high school senior.

High School Grade Point Average (GPA) on a A 4.0 Scale (unweighted) Please round to the nearest tenth (e.g., 2.95 and higher round up to 3.0)

*If GPA is weighted, please convert your weighted GPA to unweighted. Seek high school counselor’s advice on how to convert unweighted GPA * REQUIRED PROOF OF GPA: YOUR MOST RECENT OFFICIAL SCHOOL TRANSCRIPT--A Minimum of 3.0 IS REQUIRED

*To be eligible for the scholarship, you must have a 3.0 or higher GPA.

	Yes	No
Are you planning to pursue a career in medicine or social sciences?

Students pursuing careers in nursing, medicine, veterinary studies, psychology, social sciences and other associated fields do not qualify for FOSSI. Some fields of study which may be generally considered as STEM may not qualify for FOSSI scholarships. FOSSI scholars must have an approved FOSSI major throughout their 4 years of college to retain their scholarship.

Page 2

Student Information

First Name

Last Name

Gender

Gender Other

Mailing Street

Mailing City

Mailing County

Mailing State

Mailing Zip/Postal Code

Mobile Phone

Personal Email

	Email	Phone
What's the best way to contact you?

Birthdate

Age

How did you hear about the scholarship?

Other

Parent/Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Daytime Phone

Parent/Guardian Mailing Address

Parent/Guardian Mailing City

Parent/Guardian Mailing State

Parent/Guardian Mailing Zip/Postal Code

Parent/Guardian Relationship to Applicant

High School Information

High School Attended

Student ID

	1	2	3	4
Number of years attended

High School City

High School State

I will be attending the following school in Fall of 2025

	Yes	No - Undecided
Do you know what school you plan on attending?

Intended HBCU

I will be attending the following school in Fall of 2025

	Yes	No - Undecided
Do you know what school you plan on attending?

HBCU School State

Alabama Schools

Arkansas Schools

California School

Delaware School

District of Columbia Schools

Florida Schools

Georgia Schools

Kentucky Schools

Louisiana Schools

Maryland Schools

Mississippi Schools

Missouri Schools

North Carolina Schools

Ohio Schools

Oklahoma School

Pennsylvania Schools

South Carolina Schools

Tennessee Schools

Texas Schools

US Virgin Islands School

Virginia Schools

West Virginia Schools

Statement of Financial Need

Statement of Financial Need should include a description of why the scholarship is needed including loss of family income or other factors.

	Yes	No
I attest that I am in need of financial assistance for my college expenses

Household Income

Please provide a Statement of Financial Need

(200 word maximum)

Intended STEM Major

FOSSI preferred majors – Chemical Engineering, Mechanical Engineering, Electrical Engineering and Chemistry - are given priority in the selection process. Students pursuing careers in nursing, medicine, veterinary studies, psychology, social sciences and other associated fields do not qualify for FOSSI. Some fields of study which may be generally considered as STEM may not qualify for FOSSI scholarships. FOSSI scholars must have an approved FOSSI major throughout their 4 years of college to retain their scholarship.

Other Major

Page 3

We value AI as a powerful tool but expect genuine student responses. Authenticity is key; AI use is not allowed in showcasing your true self.

Extracurricular School Activities Information

Please list activities, your role in the activity and the applicable dates. Click 'Add another extracurricular school activity' to enter each additional activity.

Do you currently have a job?”

YesNo

Do you currently provide care for a loved one or family member?

YesNo

Extracurricular School Activities

Minimum of 100 words

Role

Start Date

End Date

Organization Information

Please list organizations you are now active in or have previously been active, your role in the organization and the applicable dates. Click 'Add another organization' to enter each additional organization.

Organization Description

Community organizations include service, volunteer and religious groups. Minimum of 100 words

Role

Start Date

End Date

Recognitions Information

Please list important awards and recognitions received and the applicable dates. Click 'Add another recognition' to enter each additional recognition.

Recognition Description

Minimum of 100 words

Start Date

End Date

Short Essay Questions

The chemical industry is a major driver of innovation and sustainability. How do you see yourself contributing to innovation and sustainability?

Minimum of 100 words

Each FOSSI scholar is paired with a corporate sponsor who will provide mentorship and guidance for their 4 years of college. What excites you most about this opportunity?

Minimum of 100 words

In what career do you see yourself in ten years?

Minimum of 100 words

Short personal statement

Minimum of 100 words

Optional - Video Submission of Personal Statement

25 MB Max File Size

Documentation

The following items must be attached to this application in order to qualify for the review by the scholarship committee.
Your application will be returned to you if these items are not attached; no exceptions.

	Yes	No
Have you received your acceptance letter?

Proof of acceptance at an Historically Black College or University (HBCU) for post-secondary studies. A letter of college or program acceptance is required for receipt of funds.

*This can be submitted up until April 11, 2025. *All other application materials must be submitted no later than February 16, 2025.

*This can be submitted up until April 11, 2025.

*All other application materials must be submitted no later than January 31 ,2025.

	Yes	No
Do you have your most recent transcript?

Most recent transcript

Based on the information you've provided, your counselor will receive an email asking them to provide your most recent transcript by January 31, 2025. It is recommended that you follow up with your counselor to make sure it is completed by that date.

Provide Counselors Information

Counselors First Name

Counselors Last Name

Email

Phone

Page 4

ACKNOWLEDGMENT AND RELEASE

I have read and understand the criteria and requirements and agree to all. I understand that lack of fulfillment of these criteria may result in loss of the award.

As a condition of scholarship receipt, I give permission to HBCU Week Foundation to use my name, photos, video imagery, video audio, interview content and other materials about me for promotional, publicity, marketing, or organizational purposes.

PARENT/GUARDIAN SIGNATURE IS REQUIRED ON THE FOLLOWING PAGE.