Bridge Program Application - Bridge Program - Sewanee

Review of applications will begin on April 1, 2012. After that date, applications will be reviewed individually as they are submitted.

Full Name

Preferred Name

Recent Photograph, approximately 2 x 3 inches

Permanent Home Address (Number & Street)

City

State

Zip/Postcode

Home Phone

E-Mail Address

Place of Birth

Date of Birth (mm/dd/yy)

Possible College Major/Area of Interest

Colleges you are considering

Possible Career Plans

The items in this section are optional. No information you provide will be used in a discriminatory manner.

Are you Hispanic/Latino?

Yes, Hispanic or Latino (including Spain)

No

Regardless of your answer to the prior question, please indicate how you identify yourself. (Check all that apply.)

American Indian or Alaska Native (including all Original Peoples of the Americas)

Are you enrolled?

Yes

No

If yes, please enter Tribal Enrollment Number:

Asian (including Indian subcontinent and Philippines)

Black or African American (including Africa and Caribbean)

Native Hawaiian or Other Paciﬁc Islander (Original Peoples)

White (including Middle Eastern)

Citizenship

U.S.

Permanent Resident U.S.

Other (specify below)

If you selected Other above, please specify here

Visa Type

Having a diverse academic community is important to the University. One of the goals of the Bridge Program in Math and Science is to introduce to the college rising twelfth-grade students of high academic standing whose backgrounds and experiences would contribute to and enrich the diversity within our academic community.

How do you believe you can contribute to campus diversity?

School you attend

School is

Public

Private

School Address (Number and Street)

City

State

Zip/Postcode

Guidance Couselor

School Phone

List your highest level of math and science courses (include those to be completed by the end of your junior year).

Have you ever been suspended or expelled from school for any disciplinary or honor code infraction or had any court convictions other than parking violations?

Yes

No

If you answed yes above, please explain here.

Father's Full Name

Is he living?

Yes

No

Home address, if different from yours (Number and Street)

City

State

Zip/Postcode

Occupation

Name of Business

College

Degree and Year

Professional or Grad. School

Degree and Year

Mother's Full Name

Is she living?

Yes

No

Home address, if different from yours (Number and Street)

City

State

Zip/Postcode

Occupation

Name of Business

College

Degree and Year

Professional or Grad. School

Degree and Year

Please list your brothers and sisters:

1.) Full Name

Age

College

Degree

Year

2.) Full Name

Age

College

Degree

Year

3.) Full Name

Age

College

Degree

Year

4.) Full Name

Age

College

Degree

Year

Please list your work experience and extracurricular activities

Please tell us about your computer experience. Include types of computers and software programs you are familiar with. (Note: It is important to have computer skills as you enter the science world. If you have not had much of an opportunity to work with your computer skills, we look forward to introducing you further to computing.)

Computer Experience

Please list any prior summer academic program experiences

Essay Questions

Please answer both questions.

1. Write a brief essay describing something significant you have accomplished or experienced. (500 words or less)

2. Describe recent advances in an area of science, mathematics, or technology that are interesting to you. (250 words or less)

Our signatures below indicate that to the best of our knowledge this application is complete, honestly presented, and factually correct.

Student Signature

Date

Parent Signature

Date

The following must be mailed separately.
They must be postmarked no later than April 1, 2012.

❑ Official school transcript, including standardized test scores (PSAT, SAT, or ACT) for grades 9 and 10, and first semester 11th grade.
❑ Guidance Counselor Evaluation (on school stationery, mailed separately or enclosed in a sealed, signed envelope)
Click here to download or print PDF
❑ Math or Science Teacher’s Evaluation (on school stationery, mailed separately or enclosed in a sealed, signed envelope)
Click here to download or print PDF

Please send to:

The Bridge Program in Math and Science
The University of the South
735 University Ave.
Sewanee, TN 37383-1000
or
Fax: (931) 598-1864