2009 Nanotech Camp Application

NANOTECH CAMP 2009 APPLICATION

Student Name:___________________________________________________________________________ Parent Name:____________________________________________________________________________ Address:________________________________________________________________________________ City: ____________ State: _____ Zip: _______________ Phone Number: ______________________________

County: ____________________________ Birthdate:_____________________________

E-mail: _________________________________________________________________________________ High School: _________________________________________ Fall 2008 GPA:____________________ List computer, science, technology, and math courses you have taken in high school: ________________________________________________________________________________________ ________________________________________________________________________________________ List skills, interests, hobbies, honors, and awards: ________________________________________________________________________________________ I am considering a ____ 2 year ____ 4 year college degree. List careers you are considering: ___________________________________________________________ List any employment position(s): ___________________________________________________________ Please return completed application including: A Short Essay- about why you would like to attend the camp Teacher Endorsement Form- completed by your math, science, or technology teachers Student Endorsement Form- completed by your guidance counselor or administrator Mail or fax application to: Barbara Canfield Northampton Community College 3835 Green Pond Road Bethlehem, PA 18020 Phone: 610-861-5559 Fax: 610-861-4127

NANOTECH CAMP

2009 TEACHER ENDORSEMENT The teacher endorsement form is part of the application process for a student to be selected to attend Nanotech Camp at Penn State University this summer. Nanotech Camp will introduce students to career opportunities in nanofabrication. This opportunity is being sponsored by Northampton Community College and Penn State University. Please submit a brief statement of endorsement highlighting the Nanotech Camp applicant’s qualifications. This endorsement should address the student’s strengths in math, science, or technology, (i.e.: grades, class standing, general attendance, level of commitment to the subject) and the student’s likelihood of success in a career in nanofabrication. Applicant Name:_____________________________________________________

_______________________________________________ Faculty Signature

_________________________ Date

NANOTECH CAMP 2009 STUDENT ENDORSEMENT

Dear School Counselor/Administrator: The student endorsement form is part of the application process for a student to be selected to attend Nanotech Camp at Penn State University this summer. Nanotech Camp will introduce students to career opportunities in nanofabrication. This opportunity is being sponsored by Northampton Community College and Penn State University. Students participating in the Nanotech Camp will be staying in a Penn State dorm room for two nights. They will be sharing a room with one other student. Students are expected to be able to get along well with their roommates and be respectful of the property of others. Students will be expected to conduct themselves in a respectful and courteous manner while attending this event. The selection team will need to keep this in mind when making their choices. Please take a moment to rate this student on the following factors. _________________________________CH CAMP Student Name (Please print) Attendance

Poor Above Average Good Excellent 1 2 3 4

Maturity

1

2

3

4

Commitment level- does student follow through

1

2

3

4

Courtesy towards others

1

2

3

4

Respect for others

1

2

3

4

Ability to work with others

1

2

3

4

Ability to work independently

1

2

3

4

Is student free of discipline problems

1

2

3

4

1

2

3

4

I believe this student will be an excellent school representative

Comments: ______________________________________________________________________________________ ______________________________________________________________________________________

_______________________________________________ Counselor/Administrator Signature

____________________ Date