Application Form



Women’s Engineering Explorations

A Summer Program at Temple University

Please type or print all information. Additional sheets may be attached if necessary.

Applicant Information

Name (Last, First, Middle): _________________________________________________________________

Address: __________________________________ Date of Birth: ______/______/______

_________________________________________ E-mail: ____________________________

City, State, & Zip: __________________________

Home Phone: ______________________________

Parent/Guardian Information

Name: ________________________________________________________________________________

Address: _________________________________ Home Phone:________________________ ________________________________________

City, State, & Zip: __________________________ E-mail: _____________________________

Name: ________________________________________________________________________________

Address: _________________________________ Home Phone:________________________ ________________________________________

City, State, & Zip: __________________________ E-mail: _____________________________

Academic Information

Expected date of graduation: ( 2018 ( 2019 ( 2020 ( 2021 GPA: __________________________

Name of high school: ____________________________________________________________

Activities

Please list any activities that you have participated in.

Activity Dates of participation

________________________________________________________ _________________________

________________________________________________________ _________________________

________________________________________________________ _________________________

________________________________________________________ _________________________

________________________________________________________ _________________________

________________________________________________________ _________________________

What area of engineering interests you? ________________________________________________________

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WE2 application continued

Application Materials

Essay: On a separate page, please attach an essay explaining why you want to participate in the WE2 summer program at Temple University’s College of Engineering and what you hope to gain from the experience. Your essay should be at least 150 words. Please include your name at the top of the attached page.

Letter of Reference: Please provide a letter of reference from a current teacher, guidance counselor, or other non-relative adult. This letter should be in a sealed envelope with the recommender’s signature across the flap of the envelope.

← High School Transcript (Please include an official high school transcript with your application form.)

← Citizenship information (For NASA trip)

← Forms (after acceptance to program):

• Parental/Guardian Consent and Release

• Acknowledgement of Confidential Information Policy

• Image Consent and Release

• Consent for Medical Treatment

Application Deadlines and Decision

The application deadline is June 1, 2018. Applications will be considered as they are received, and applicants will be notified within 2 weeks. Decisions will be based on the applicant’s essay, letter of recommendation, and high school transcript. All interested students are encouraged to apply.

Program Fees

The cost of the program is $500 per participant. Once accepted, a non-refundable fee of $50.00 is required as a deposit within 2 weeks of notification of acceptance. The remainder of the fee will be due no later than June 30, 2018. No financial assistance is available for this program.

If you have any question regarding the WE2 program, please contact Dr. Golriz Kermani at wengr@temple.edu

or contact the department at 215-204-7808.

How did you hear about the Women’s Engineering Explorations (WE2) program?

( Parent/Guardian

( Teacher/Guidance counselor

( Friend

( Posted flyer ( College of Engineering website

( From college fair

( Internet search

( Received flyer in mail

( Email

( Other

Temple University is committed to a policy of equal opportunity for all in every aspect of its operation. The University has pledged not to discriminate on the basis of race, color, sex, age, religion, national origin, sexual orientation, martial status, or disability. This policy extends to all educational, service, and employment programs of the University. For more information or to review Temple University’s Affirmative Action Plan, contact the Office of Affirmative Action, 109 University Services Building, (215) 204-7303.

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Please email the completed application and required application materials to wengr@temple.edu

or mail to: Dr. Golriz Kermani

Department of Mechanical Engineering, 6th Floor

College of Engineering

Temple University

1947 N. 12th Street

Philadelphia, PA 19122

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