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Engines
of Our Ingenuity Scholarship Application
For current University of Houston students
Application Deadline: May 1
Note: Use the
TAB key to move between fields. By hitting the ENTER key at any point,
you will be submitting your application.
Last Name:
First:
Middle:
S.S/Student ID #:
Sex:
Marital Status:
Race/Ethnic Origin: (optional)
Permanent Address:
Street:
City:
State/Country:
Zip Code:
Telephone:
Local Address:
Street:
City:
State/Country:
Zip Code:
Telephone:
Email Address:
Place of Birth:
Date of Birth:
U.S. Citizen?
Permanent Resident?
Texas Resident?
Classification at the University of Houston:
Your major:
GPA:
What activities have you been involved with that show your abilities for "Creative - Thinking"?
List memberships and positions held in organizations or
societies.
What honors or special recognitions have you received?
To complete this form for submission
BY MAIL, please sign, date and send it to the address below.
I certify that the information is correct, and I hereby
grant permission to the University of Houston to release all of my student
records to potential scholarships sponsors.
Applicant's Signature:
Date:
Please return this application to:
University of Houston Cullen College of
Engineering
Dean's Office, Attn: Engines of Our Ingenuity Scholarship Committee
E421 Engineering Bldg 2
Houston, TX 77204-4007
OR
By submission of this ELECTRONIC FORM,
I certify that the information is correct, and I hereby grant permission
to the University of Houston to release all of my student records to
potential scholarship sponsors.
Date:
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