SUMMER APPRENTICESHIP PROGRAM (SAP)
KENTUCKY STATE UNIVERSITY
June 23rd to July 14th, 2024
All application packages must be received or postmarked by May 25, 2024. Application packages postmarked after the deadline may not be accepted. Incomplete applications will not be considered.
Eligibility Requirements:
Rising high school junior/senior
Interest in STEM (Science, Technology, Engineering, and Mathematics) and related fields such as Agriculture and Environmental Studies
A preferred minimum GPA of 3.0
Applicant Information
First name Middle name Last name
First name
Middle name
Last name
Email___
Email
Street ___ Apt #___
Street
Apt
City _____ State _____ ZIP _____
City
State
ZIP
County_____ Phone_____
County
Phone
Social Networking Facebook □ Instagram □ Twitter □ Other □
Instagram
Twitter
Other
(Roommate requests are accommodated when both
Race/Ethnicity ___
Race/Ethnicity
Personal Information
Gender ☐ Female ☐ Male Birthdate (MM/DD)___ ___
Female
Male
Birthdate (MM/DD)
Age (by June 23, 2024) ___ T-shirt Size ___
Age (by June 23, 2024
T-shirt Size
Name of the school you currently attend: ___
___
Grade level completed by June 23rd
Grade level completed by June 23rd, 2024 └── 10th └── 11th
10th
11th
Expected Graduation Date: Month/Year___
Expected Graduation Date: Month/Year
(Roommate requests are accommodated when both individuals mutually request each other)
If possible, I would like to room with:
with
Parent/Guardian Contact Information
Alternative Emergency Contact Information
First name Middle name Last name ___
Evening phone_____
Evening phone
Day phone_____
Day phone
Cell phone_____
Cell phone
Email___ First name Middle name
Email
<div style="text-align: center;"><img src="imgs/img_in_image_box_0_0_1055_122.jpg" alt="Image" width="99%" /></div>
First name
Last name
Middle name
First name
Middle name
Last name
First name Middle name Last name
Last name
Evening phone_____
Evening phone
Day phone_____
Day phone
Cell phone_____
Cell phone
Email ___
Email
This program is supported by National Science Foundation Historically Black College and Universities-Undergraduate Program (NSF-HBCU-UP) to promote minority students' participation in STEAM-undergraduate degree programs.
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