First Name:     Last Name
Student ID (not SSN)
E-mail:
Gender:   Male  Female
[1] What degree are you seeking?  Associate Degree Baccalaureate Degree   Certificate
[2] Select your CIT track:   select one Standard Business Web development Networking/Technical
[3] Enter the number of hours complete towards your degree:
[4] When did you graduate or when do you expect to graduate?
[5] What is your cumulative GPA?
[6] Is English your second language? Yes or No? Yes No
If so, where did you attend high school, and in what language:
[7] Are you a single parent?  Yes or No? Yes No
[8] What is your ethnicity?
[9] List the programming courses you have taken and grade received:
[10] Are you an officer of student organization? Yes or No? Yes No
If so, which one(s):
[11] Please describe your involvement with any student organizations or extra curricula activities.
[12] Please select all of the awards you think you are eligible for:
Outstanding Underclassmam	Outstanding Associate Degree
Outstanding Upperclassman	Outstanding Baccalureate Degree
Jessie Lennertz Award	ASM Award
Outstanding Foreign Student	Nicholas J Kira Scholarship
Brancato Scholarship	Charles K. Barker Award
John G. Williams, Jr. Memorial Award	ACM Award
Grace Murray Hopper Programming Award	Outstanding CIT Woman
United Parcel Service NSBE Achievement Award	Outstanding Woman Scholar Award
Alfred R. Potvin and Janet H.Potvin Outstanding Student Leader and Scholar Award
[13] Explain how you meet the criteria for this award. (Refer to the awards page for details.)

IMPORTANT!  
Please make sure your email address is correctly typed.