HBCU Scholarship Program Application

North Carolina
HBCU/MSI Transportation
Scholarship Program Application Form
2020-2021 Academic Year

General Instructions for Applicant:

Please read and review the N.C. HBCU/MSI Transportation Scholarship Program Overview and the scholarship brochure.
Applications are only accepted online by 5 p.m. on Oct. 2. Do not mail your printed responses. These applications will be discarded.
Your application is the first impression you will make upon those who award scholarships. Please check for spelling, grammar and clarity.
Contact your faculty advisor or career development director, if you need assistance.
It will take approximately one hour to complete this application. It must be completed in one sitting. A save and complete later function is not available.
To complete this application you will need:

Resume;
One letter of recommendation;
An unofficial transcript;
Note: If uploaded, name and email address are required (see bottom of form)
If you are not a United States citizen, you must submit a CERTIFIED copy of Certificate of Eligibility (SEVIS I-20) or Permanent Resident Card (Form I-551) issued by the C.I.S., if applicable.

* I agree I have read the scholarship program overview.
Required

North Carolina HBCU/MSI Transportation
Scholarship Program Application
2020-2021 Academic Year

Applications MUST be completed online.

Printed/Handwritten and incomplete applications will not be considered.

* Indicates required field

(Click the Reset button at the bottom of the form to clear all form fields)

* Full Name: Required

* Current Mailing Address:
(where you receive U.S. Postal Mail)
Required

* City: Required

* State:

* ZIP: Required

Permanent Mailing Address:

Permanent City:

Permanent State:

Permanent ZIP:

Preferred Name:

* Date of Birth: Invalid Date Format. Please enter valid date, ex. MM/DD/YYYY

* Phone Number:
Include area code
Invalid Phone Format. Please enter a valid phone number, ex. (999) 999-9999

* Alternate Contact Person's Name: Required

* Phone Number:
Include area code
Invalid Phone Format. Please enter a valid phone number, ex. (999) 999-9999

Check one box and choose year to indicate your status as of 9/1/2020

Degree:

Bachelor's

Master's

Please select a radio button for degree.

Year:

First

Second

Junior

Senior

Please select a radio button for year.

Are you a full-time student?

Yes

No

Please select a radio button for full time student status.

Are you a U.S. citizen?

Yes

No

Please select a radio button for U.S. Citizenship.

If no, please attach a CERTIFIED copy of Certificate of Eligibility

(SEVIS I-20) or Permanent Resident Card (Form I-551) issued by the C.I.S.

Gender:

Male

Female

Non-binary

Race/Ethnicity (optional):

American Indian

Alaskan Native

Asian

African/African American (Non-Hispanic or Latino)

Native Hawaiian/Other Pacific Islander

White (Non-Hispanic or Latino)

Other

Hispanic or Latino

Two or More Races (Non-Hispanic or Latino)

Education/Experience

Experience in Other Transportation Education Programs:

ENO Fellow - Yr.

National Summer Transportation Institute - Yr.

Dwight David Eisenhower Transportation Fellowship Program - Yr.

University Transportation Centers Award - Yr.

Summer Transportation Internship Program for Diverse Groups - Yr.

* College/University (must be a North Carolina HBCU/MSI):

Required

* Academic Department:

Required

* Current GPA:

Required

* Unofficial Transcript (indicate if uploaded or mailed):

Please select a radio button for Uploaded or Mailed.

Uploaded

Note: If uploaded, name and email address are required (see bottom of form)

Mailed

* Expected Graduation Date (i.e. Spring 2021):

Required

* Applicant's Major (Must be a transportation related field - see list in program brochure):

Required

* Applicant's Field of Study (i.e. Traffic Studies, Physical Planning):

Required

Letter of Recommendation Contact Information

* Name: Required

* Title: Required

* Mailing Address: Required

* City: Required

* State: Required

* ZIP: Required

* Phone Number:
Include area code
Invalid Phone Format. Please enter a valid phone number, ex. (999) 999-9999

* Email Address: Please enter a valid email address, ex. name@example.com.

Application Statements

Personal Statement
Describe how your education will prepare you for a career in transportation. This personal statement should include relevant background and future goals.
(Limit 1000 words)

Required

Work History
Please provide your work experience, including paid/unpaid summer internships and volunteer work experience, like Peace Corps.
(Limit 1000 words)
You must attach your resume at the bottom of this form. Please limit your resume to two pages.

Required

Financial Statement
The Financial Statement should include pertinent information that provides the committee a general overview of your financial need. Please share cost of education at your university/college including, but not limited to the following: tuition, room, books and fees. Include all additional scholarships and financial support you are receiving. How will this scholarship help your ability to matriculate through your HBCU/MSI?
(Limit 1000 words)

Required

Name, Email Address and Required File Uploads

IMPORTANT NOTE: Once you press the submit button you will not be able to return to this application. This application does not have a save and return mechanism. You can only apply once.

Upload Requirements:

All files must be selected at the same time - Upload all files at once

How to select multiple files to upload:

Store all files for upload in the same folder on your computer
Click Browse button and navigate to the folder where the files are stored
For individual files: Hold down the Ctrl key and click individual file(s) for upload
For a group of files: Click the first file you want to select, hold down the Shift key and click the last file you want
After you release the Ctrl or Shift key, click the Open button

Uploads are limited to a maximum of 9 files
Uploads are limited to a maximum upload size of 25MB

Name, Email Address & Uploads

By submitting this application, I certify to the statements contained in this document and that the statements herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances and agree to comply with any resulting terms if I accept an award. I am aware that any false, fictitious or fraudulent statements or claims may subject me to criminal, civil or administrative penalties and your scholarship will be rescinded.

Please enter your name, email address and upload unofficial transcript, resume and letter of recommendation.

Name: Required

Email Address: Please enter a valid email address, ex. name@example.com.

Upload Files:

If for some reason you are not able to upload your files, please email them to hbcuprograms@ncdot.gov

Validating Fields

Submitting Form

Submit Reset

HBCU Scholarship Program Application

General Instructions for Applicant:

North Carolina HBCU/MSI Transportation Scholarship Program Application 2020-2021 Academic Year

Check one box and choose year to indicate your status as of 9/1/2020

Are you a full-time student?

Are you a U.S. citizen?

Gender:

Race/Ethnicity (optional):

Education/Experience

Experience in Other Transportation Education Programs:

* College/University (must be a North Carolina HBCU/MSI):

* Academic Department:

* Current GPA:

* Unofficial Transcript (indicate if uploaded or mailed):

* Expected Graduation Date (i.e. Spring 2021):

* Applicant's Major (Must be a transportation related field - see list in program brochure):

* Applicant's Field of Study (i.e. Traffic Studies, Physical Planning):

Letter of Recommendation Contact Information

Application Statements

Name, Email Address and Required File Uploads

Upload Requirements:

How to select multiple files to upload:

Name, Email Address & Uploads

North Carolina HBCU/MSI Transportation
Scholarship Program Application
2020-2021 Academic Year