Science, Mathematics and Research for Transformation (SMART) Scholarship Program

Registration Fields
Citizenship Status

I am a US citizen born in the US or a US territory/possession
I am a US citizen not born in the US or a US territory/possession
I am not a US citizen

All applicants must be US citizens.

Birth Date

Month

Day

Year

You must be 18 years old as of August 1, 2014 to apply.

Employment
Have you applied to the SMART Scholarship program before?
Are you a current SMART Scholar applying for a follow-on award?
Are you a former SMART Scholar?

Yes

Yes
Yes

No
No

No

Please indicate your most recent award year if you are a former or current SMART Scholar
Proposed Degree
Information Sharing
I agree that my contact information may be shared with other DoD organizations for the purpose of receiving
information about other opportunities such as research experiences, scholarships, and fellowships.
ASEE SMART Correspondence
I understand ASEE will contact me via email to remind me of missing materials and application deadlines, and
award notifications.
Privacy Act Statement

I have read and agree to the Privacy Act Statement.

Contact Information
First Name
Middle Name
Last Name
Suffix
Other Name
Resident State
Email

Permanent Address
Street

City
State
Zip/Postal Code
Primary Telephone
Alternate Telephone

Citizenship and Demographics
Are you registered with the Selective Service?

I am not required to register?

Yes

No

Please visit www.sss.gov for more information.
City of birth
State of birth
Country of
birth

(If applicable) I am a dual citizen of the United States
and

(If applicable) I was a dual citizen of the United States
and

Incomplete or inaccurate reporting of citizenship status may result in disqualification.
Demographic information
This information is used to determine the degree to which members of diverse sections of the eligible
population are aware of and apply for this program. See the Privacy Act Statement for more information. This
information will not be provided to evaluators and will not impact your eligibility in any way.
The following information is voluntary, if you do not wish to answer the questions, simply select the "I do not
wish to respond" option under each question.
Gender
Ethnicity

Male

Female

I do not wish to respond

Hispanic or Latino

Not Hispanic or Latino

Race

Select all that apply:

American

Native Hawaiian or Other Pacific Islander

Disability

I have a disability

I do not wish to respond

American Indian or Alaska Native
White

I do not have a disability

Asian

Black or African

I do not wish to respond
I do not wish to respond

Veteran Preference
claimed

No preference claimed

10 points preference claimed

If you are claiming the 5 point preference, you must submit:


a copy of your DD-214.

If you are claiming the 10 point preference, you must submit, a copy of your:




DD-214
SF-15
letter from the VA (including a VA POC)

The forms must be received by December 01, 2015

5 points preference

Academic Background
Current academic status
Select your current academic status and the name of your current academic advisor. If you are not currently
enrolled in an academic institution (applicants seeking funding for undergraduate studies must be currently
enrolled), select the highest level completed in your academic career.
If your academic status is 1st year Associate's Program or Freshman you must submit a SAT or ACT score.
Current Academic Status
Do you currently have an academic advisor?

No

Yes

The following fields are only required if you have an academic advisor.
Academic Advisor
Advisor Email
Advisor Title
Enter information about each educational institution you attend or attended.

Please list all colleges attended. You are required to submit a transcript for any completed college
coursework. If you are currently enrolled, you must maintain a 3.0 GPA to remain eligible for a SMART
Scholarship Award.
School
Level of coursework
Degree Status
Declared Major
Are you currently enrolled in this institution?
Cumulative GPA
GPA Credits
Attended from

Yes

No

Attended to
Please list expected graduation date if you are currently attending this school.
Transcript
View existing transcript
Required for all schools started prior to Fall 2015

Proposed Area of Study
You must have been accepted for admission into an eligible program by the time of the award.
To modify your proposed institution, search for the institution below.
If you have not decided on an institution, select "Undecided" below.

Proposed Institution
Undecided

Select if you do not have a proposed institution

Proposed Degree

Start date of program

Month

Estimated date of completion Month

Year
Year

Are you currently enrolled in the degree program for which you seek funding?

Yes

Discipline
Please select the discipline to which your particular course of study is most closely related.
Sub Disciplines
Sub Discipline (other)
Name of Academic Program/Major

No

Placement Preferences
For which services/agencies do you want to work?
Select three, in order of preference. If you have no particular preference, select "No preference."
For more information on the sponsoring facilities, click here.
Selecting a preference or preferences will neither increase nor decrease your chances for a SMART
scholarship. This information is used after initial candidate selection to help determine organization
placement. The SMART Program does not guarantee that, if selected, you will be placed at your
preferred organization.
First

Other
If you selected 'Other, not in this list' for your first choice

Second

Other
If you selected 'Other, not in this list' for your first choice

Third

Other
If you selected 'Other, not in this list' for your first choice

Geographic placement preferences
Select up to three regions, in order or preference.
Selecting a preference or preferences will neither increase nor decrease your chances for a SMART
scholarship. This information is used after initial candidate selection to help determine organization
placement. The SMART Program does not guarantee that, if selected, you will be placed in your
preferred geographic region.
First

Second
Third

Professional Experiences
Upload Resume or CV (PDF only)

Summary of Educational and Professional
Goals
In a concise statement, provide a summary of your current educational program objectives and your long-range
professional goals.
It is crucial that you address each of the following:



Why you want to work for the Department of Defense?
How do you think that you will benefit from working as part of the DoD civilian workforce?

Retention applicants also need to address the following:


How will this academic program and resulting degree benefit the DoD? Please be specific.

Your response will be limited to 5000 characters, including spaces. You must enter a minimum of 2500 characters.
Please cite any sources used in your statement.
Click "Save" when you are done.
Characters (2,500 min, 5,000 max), 5,000 remaining

Interests and Research Explanation
Please discuss each of the following:



The factors and experiences that led you to choose your field of study
Specific challenges or problems in your field that most interest you and why

Your response will be limited to 5000 characters, including spaces. You must enter a minimum of 2500 characters.
Please cite any sources used in your statement.
Click "Save" when you are done.
Characters (2,500 min, 5,000 max), 5,000 remaining

Community and Volunteer Work
Provide a summary of volunteer work and experiences, interests, and/or hobbies. Include the approximate number
of hours a week for each experience and a reference for each experience with the reference's name and contact
information for verification. If there is no specific contact person, please list someone at the organization who can
confirm your experience.
Your response will be limited to 1000 characters, including spaces.
If you do not have any community or volunteer work to report, indicate this by typing "None". Please do not type
"see attached" or refer to other documents in this field.
Click "Save" when you are done.
Characters (4 min, 1,000 max), 1,000 remaining

Leadership Experiences
Describe or list any leadership experiences, such as class president, committee chairperson, or scouts. Include
dates and a reference for each experience, along with the reference's name and contact information for
verification. If there is no specific contact person, please list someone at the organization who can confirm your
experience.
Your response will be limited to 1000 characters, including spaces.
If you do not have any leadership experiences to report, indicate this by typing "None." Please do not type "see
attached" or refer to other documents in this field.
Click "Save" when you are done.
Characters (4 min, 1,000 max), 1,000 remaining

Teamwork Experiences
Describe or list any teamwork experiences (including research or academic projects as well as varsity sports,
extracurricular groups, or clubs). Include dates and a reference for each experience, along with the reference's
name and contact information for verification. If there is no specific contact person, please list someone at the
organization who can confirm your experience.
Your response will be limited to 1000 characters, including spaces.
If you do not have any teamwork experiences to report, indicate this by typing "None." Please do not type "see
attached" or refer to other documents in this field.
Click "Save" when you are done.
Characters (4 min, 1,000 max), 1,000 remaining

Publications and Presentations
Enter all publications and presentations pertaining to your field since entering college. These may include articles,
journal submissions, and conference proceedings.
If you do not have any publications or presentations to report, indicate this by clicking on the "No publications or
presentations to report" check box and then the "Save" button.
No publications or presentations to report.

Awards & Honors
Enter all scholarships, academic honors, scientific or engineering student leadership roles, honorary societies, and
any other recognition relevant to your field since entering college. All awards and honors granted by the U.S.
Government should have the "Federal Award" box checked, with the agency granting the award specified in the
description, such as NASA or the NSF.
If you do not have any awards to report, indicate this by clicking on the "No awards or honors to report" check box
and then the "Save" button.
No Awards or Honors to report

References
Enter contact information for at least three (3) references in order to send a request to each. References should be
scientists, engineers, faculty members, or others who have current or recent knowledge of your academic
accomplishments or your professional experiences. They will be contacted electronically with instructions on how
to submit a reference letter once you enter the reference provider's information. You may add up to five (5)
references; however, only three (3) will be used. You may rank the order in which they will be used and the top
three (3) completed references will be the ones used.
Reference letters must be uploaded to your application by December 01, 2015; however, you may update your
references at any time even after you have submitted your application, up until December 01, 2015. You may
monitor the status of your references by looking at the Application Status page.
Reference letters must be on official letterhead. Reference letters not on official letterhead may be disqualified
from consideration. If your reference provider is unable to use official letterhead, please instruct them to include
an explanation as to why they were unable to use official letterhead.
It is the applicant's responsibility to follow-up with the reference providers to make sure the references are
completed by December 01, 2015. Common reasons for reference request emails failing to reach the reference
listed are applicants providing incorrect reference email addresses and reference request emails being blocked by
SPAM filters.
Reminder emails can be sent to any of your references by clicking the "Send reminder email" link located beneath
each reference.
Add new reference
Rank
Name
Email
Position
Department
Institution

Rank
Name
Email

Position
Department
Institution

Rank
Name
Email
Position
Department
Institution

Rank
Name
Email
Position
Department
Institution

Rank
Name
Email
Position
Department
Institution

Outreach
How did you hear about the SMART Program? Please select all that apply.
Heard about it from a friend
Heard about it at a conference
Informed by a faculty member
Internet website
Learned about it in a grants office
Saw announcement on a bulletin board
Government agenc
y

Government newsletter or publication
Career or Graduate School Fair (please describe)
Campus Presentation (please enter the school name

)

Other (please describe)

Please provide additional information here:

Previous Program Experiences
Have you participated in a Department of Defense educational program? Please select all that apply.
Center for Excellence in Education RSI Program
College Qualified Leaders (CQL)
DoD Sponsored Internship in a College/University Laboratory
eCYBERMISSION Program
FIRST Robotics Program
Gains in the Education of Mathematics & Science (GEMS) Program
High School Apprenticeship Program (HSAP)
Intel International Science & Engineering Fair (Intel-ISEF)
Internship in a DoD Laboratory
Junior Science & Humanities Symposium (JSHS)
Junior Solar Sprint (JSS)
La Luz Academy
National Defense Education Program (NDEP) K-12
National Defense Science and Engineering Graduate Fellowship Program (NDSEG)
National Science Center
Naval Research Intern Program (NREIP)
Research & Engineering Apprenticeship Program (REAP) Science Institute

Science & Engineering Apprenticeship Program (SEAP) - Army
Science & Engineering Apprenticeship Program (SEAP) - Navy
Science & Engineering Apprenticeship Program Science and Technology Academies Reinforcing Basic
Aviation and Space Exploration (STARBASE)
Uninitiated Introduction to Engineering (UNITE)
Women in Science Project (WISP)
Other DoD Educational Program(s) (please describe):

PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 2192a, as amended; P.L. 109-163; and E.O. 9397 (SSN), as amended.
PRINCIPAL PURPOSES: To evaluate a SMART Applicant's qualifications for a SMART Scholarship
ROUTINE USE(S): A record from a system of records maintained by a DoD Component may be disclosed as a routine use to a
federal, state, or local agency maintaining civil, criminal, or other relevant enforcement information or other pertinent information,
such as current licenses, if necessary to obtain information relevant to a DoD Component decision concerning the hiring or retention
of an employee, the issuance of a security clearance, the letting of a contract, or the issuance of a license, grant, or other benefit.
DISCLOSURE: Failure to furnish the requested information on this form will result in SMART Participant not being non-compliant
with SMART policy and subject to possible dismissal.

Agency Disclosure Notice
The public reporting burden for this collection of inforamtion is estimated to average 8 hours per response, including the time for
reviewing instructions, searching existing data sourses, gathering and maintaining the data needed, and completing and reviewing
the collection of information. Send comments regardign this burden estimate or any other aspect of this collection of inforamtion,
including suggestions for reducing the burden, to the Department of Defense, Washingotn Headquarters Services, Executive
Services Directorate, Directives Division, 4800 Mark Center Drive, East Tower, Suite 02G09, Alexandria, VA 22350-3100 OMB
Control Number:0704-0466. Respondents should be aware that notwithstanding any other provisions of law, no person shall be
subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.