DEADLINE: Complete this application by Saturday, October 21, 2017 Part I Personal Information First Name * Last Name * Duke Unique ID (7-digit number) * Email Address * Phone Number Local Mailing Address Permanent Mailing Address Graduation Information Your GPA * Class Sophomore Junior Senior Planned Graduation Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2016201720182019202020212022202320242025 Major(s) * One major per line. List primary major first. Minor(s) If applicable, list one minor per line. Certificate Program(s) If applicable, list one program per line. Honors Please list any academic or professional awards you have received, including scholarships, fellowships, prizes, awards, honorary societies, publications, inventions, or other creative work: Honors One item per line. Part II Work, Activities, Background and Volunteer Experience If you are currently employed at Duke, please list your job, name of employer, department, and type of job (work/study or other). Will you be working at Duke during the fall semester 2017? Yes No If Yes, list where: Will you be working at Duke during the spring semester 2018? Yes No If Yes, list where: Please list any other work experience such as summer jobs, previous work-study, or other employment or volunteer work, including dates: Have you had previous experience or are you currently involved in teaching, mentoring, or interacting with K-12 students? If so, describe these activities briefly and list the age group of the students. This can include educational, camp, volunteer, and/or sports activities (If none, list none): Detail in the box below: Do you have background and interest in website development? Yes No If Yes, please describe briefly: Part III Essay Please prepare an essay document which answers the following three questions. Then below, click the 'Browse ..." button to upload your essay as a PDF document. Question 1: Please provide a brief (approximately 1 page) statement describing your interest in the program, your background, career goals, and how they relate to the Boeing Grand Challenges K-12 Outreach Fellows Program. Question 2: Explain the value of introducing young students in elementary, middle, and high school, to STEM disciplines. Mention, if applicable, any personal experience that influenced your decision to become an engineer. Question 3: Please provide a statement (1/2 page) of your intended career goals following graduation [for example, graduate school (state in what field and for what degrees), medical school, industry (state what kind of industry and likely position, such as engineering business, research, or consulting), or education (for instance, K-8, high school, or college teaching or other (such as Teach for America, Peace Corps)]. Upload Essay PDF * You must submit in PDF file format. Use the file name format of YourLastName_YourFirstname.pdf. Maximum file size: 10 MB
