Gulf Coast Section of Society of Petroleum Engineers

APPLICATION FOR UNDERGRADUATE

SCHOLARSHIP IN PETROLEUM ENGINEERING & RELATED FIELDS

Name _______________________________________________________________________________
First
Middle
Last
Home Address________________________________________________________________________
Number
Street
City
State Zip Code County
Telephone (______)_____________________ Email_________________________________________
Date of Birth __________________________
Month
Day
Year
Citizenship U.S.A Resident Alien USA Naturalization # OR Application #_____________

Guardian Full Name__________________________________________________

Address _______________________________________________________________________
Family Members in SPE and Relation (if applicable)
Full Name___________________________________Relation___________________________________
Full Name___________________________________Relation___________________________________
Full Name___________________________________Relation___________________________________
Full Name___________________________________Relation___________________________________

Please indicate below, by a check, the yearly income of your family.

Less than $50,000
$100,000 to $150,000
$200,000 and above

_____
_____
_____

$50,000 to $100,000
$150,000 to $200,000

_____
_____

If you wish us to consider need, please write a paragraph explaining why:

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

NAME_________________________________

High School______________________________________ School District________________________

High School Address___________________________________________________________________

Name of School Counselor________________________________ Phone Number_________________

Number in your graduating class___________________ Your Class Rank_______________________

Grade Point Average ___________________out of a possible __________________________________

SAT Total (1650 minimum) _________Verbal ____________Math ____________Writing___________

SAT Subject Tests:
Math Level 1___________Math Level 2
Chemistry____________ Physics_______________
ACT Composite___________________Verbal____________Math____________Writing____________

College Major 1.___________________________________2.__________________________________

College Preference

Accepted?

1._______________________________________________________

_________________

2._______________________________________________________

_________________

3._______________________________________________________

_________________

What other scholarships, grants, etc. have you applied for, received? Be specific.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

EMPLOYMENT WHILE IN HIGH SCHOOL

Date (fromto)
Type of Work

Employer's Name, Address, & Phone

_______________

______________________

___________________________________

_______________

______________________

___________________________________

_______________

______________________

___________________________________

NAME_________________________________
HIGH SCHOOL, SPECIAL RECOGNITION, & COMMUNITY VOLUNTEER ACTIVITIES
List the activities in which you participated in the order that brought you the most satisfaction, pride, and
pleasure, including any recognition you received. Include the years you were active (9, 10, 11, 12) and any office
you held. Do not repeat the activity for each year. Examples: publications, debate, clubs, student government,
athletics, band, FFA, Honor Society, Student Council, National Merit, Scouts, community service activities,
hospice, SPCA, and contests. (If necessary, attach additional sheets for activities.)
YEAR
ACTIVITY HONORS, OFFICE HELD, RESPONSIBILITY, ETC.
Membership, Activities, and Awards not related to math and science (NHS, National Merit, National
Hispanic Scholar, National Achievement Scholars, Outstanding Negro Students, Scouts, Student Council,
Yearbook, clubs, etc)
1. _______ _______________________ _________________________________________________
2.

_______ _______________________ _________________________________________________

3.

_______ _______________________ _________________________________________________

4.

_______ _______________________ _________________________________________________

5.

_______ _______________________ _________________________________________________

Community Service and Volunteerism (Habitat for Humanity, Big Brothers/Big Sisters, Walk-A-Thons,
Junior Achievement, shelters, hospitals, church activities, etc)
6. _______ _______________________ _________________________________________________
7.

_______ _______________________ _________________________________________________

8.

_______ _______________________ _________________________________________________

9.

_______ _______________________ _________________________________________________

10. _______ _______________________ _________________________________________________

Activities and Awards related to math or science (JETS, National Math League, Mu Alpha Theta, UIL
Math/Science/Calculator/Number Sense competitions, Science Fair, Academic Decathlon, etc.)
11. _______ _______________________ _________________________________________________
12. _______ _______________________ _________________________________________________
13. _______ _______________________ _________________________________________________
14. _______ _______________________ _________________________________________________
15. _______ _______________________ _________________________________________________

Teamwork (Athletics, Band, Dance, Cheerleading, First Robotics, History Fair, etc)
16. _______ _______________________ _________________________________________________
17. _______ _______________________ _________________________________________________
18. _______ _______________________ _________________________________________________
19. _______ _______________________ _________________________________________________

20. _______ _______________________ _________________________________________________

3

NAME_________________________________

Additions to be included with this application:

1) WRITE AN ESSAY of 250 words or less and attach it to this application. Tell why you have chosen a
career in a petroleum-related field. How will you apply this career in your future? Be specific!
2) SUBMIT AT LEAST TWO LETTERS OF RECOMMENDATION
1. High School Counselor
Email:_____________________________________
2. High School Teacher or Principal
Email:_____________________________________
3. Industry Representative
Email:_____________________________________
3) INCLUDE AN OFFICIAL TRANSCRIPT OF YOUR HIGH SCHOOL RECORD INCLUDING THE
FIRST SEMESTER OF YOUR SENIOR YEAR (can be a copy of your official report card).
Final selection depends on face-to-face interviews by members of the Scholarship Committees.
NOTE: Any undergraduate scholarship awarded by the Gulf Coast Section of the Society of Petroleum
Engineers is contingent upon the recipient's official registration at an accredited university or college and
enrollment in a curriculum leading to a degree in petroleum-engineering-related fields. U.S. Citizenship or
application for it is required.
_____________________________________________
SIGNATURE OF APPLICANT

THIS SCHOLARSHIP IS FOR $1,500/SEMESTER.

RECEIVED BY FEBRUARY 11, 2013.
SEND COMPLETED APPLICATION TO:

COMPLETED APPLICATIONS MUST BE

gcsscholarship@spemail.org

YOUR ENTIRE APPLICATION MUST BE PRESENTED ON SINGLE-SIDED 8 1/2 x 11. A digital copy of
this application can be located on the SPE-GCS Home Page at www.spegcs.org. APPLICATIONS WILL NOT
BE CONSIDERED UNLESS THEY ARE COMPLETE (Include ALL information requested or explain why you
cannot furnish it) AND INCLUDE THE FOLLOWING:
1.
2.
3.
4.

Essay (250 words or less)

Two letters of recommendation (no more than three)
Official transcript of high school record
Proof of your SAT or ACT score (can be part of your Official transcript, does not have to be separate)

**If you not able to obtain an electronic copy of the Letter of Recommendation, then please

have the writer email it to:gcsscholarship@spemail.orgwith the students name in the subject
heading or postage mail it to the Scholarship Committee using the address listed below. This
also applies to your transcripts. If you are not able to get a copy, have your counselor send it
to the Scholarship email address gcsscholarship@spemail.org with the students name in the
subject heading or postage mail it to the Scholarship Committee using the address listed
below
SPE-GCS Scholarship Chairman
SPE Gulf Coast Section
10777 Westheimer Rd., Suite 1075
Houston, TX 77042

The SPE Scholarship Committee prefers everything be sent electronically.