Full Legal Name *

Permanent Address: *

Primary Phone: *

Email Address *

Current level of education *

Approximate GPA *

Date of birth *

Planned major/field of study *

Current School

What School are you planning on attending in the fall? *

List college and high school extracurricular activities (student government, sports, publications, school-sponsored community service, arts, music, etc.) *

List public service and community activities (volunteer, advocacy activities, etc.). Do not repeat items listed previously *

Essay Questions

Read the following questions carefully and provide a thoughtful, original answer to each.
The word count for each question is limited to 350 words or less.

1. Why are you pursuing higher education in science? *

2. How do you intend to make your mark as a woman in science?

3. How has balancing extracurricular activities and schoolwork made you better prepared for higher eduction? *

4. What community service activities do you participate in?

5. How has financial hardship or other limiting factors impacted your education? *

6. It's The Year 2040 and you are being awarded the Nobel Prize. Why? *

7. Why do you deserve this scholarship? *

8. What has been your proudest achievement so far? *

Additional Essay Questions - 1 or 2 to complete.

Who or what inspired your interest in perusing a degree in science?

If you could collaborate with any scientist, living or deceased, who would it be and why?

How do you envision using higher education to make a positive impact on society, particularly for women and underrepresented groups?

Describe a project or experiment you've worked on that you are particularly proud of. What were the challenges, and what did you learn from the experience?

Reflect on a recent breakthrough or development in your chosen field of science. How does this inspire or influence your career aspirations?

Letter of Recommendation *

Maximum upload size: 134.22MB

I have read and understand the conditions of the “Dr. Patti Flint Women in Science Scholarship” as explained in the current Overview, Privacy Notice, and Eligibility Requirements sections. I affirm that I plan to pursue an education or career in hard science as defined in those sections. I understand that this application will be available only to scholarship committee in the course of their duties. If selected as recipient of the Dr. Patti Flint Women in Science Scholarship, I agree to attend a higher education institution located in Arizona and furnish proof of my enrollment and relevant course load once available. I also agree to furnish information necessary to issue a 1099 tax form as part of the process for dispersing scholarship monies. I acknowledge that I will be responsible for any resulting tax obligations. I affirm that all of this application is my own work. I affirm the information contained herein is true and accurate to the best of my knowledge and belief at the time of submission.

Digital Signature *

Date *