975 NRC Minority Serving Institutions Grants Program (MSIGP)

U.S. NUCLEAR REGULATORY COMMISSION

NRC FORM 975
(MM-DD-YYYY)

NRC Minority Serving Institutions Grants
Program (MSIGP) Service Agreement for
Grant Fellowships, and Scholarships to
Colleges, Universities and
Trade/Community Colleges

APPROVED BY OMB: NO. 3150-XXXX

EXPIRES: (MM/DD/YYYY)

Estimated burden per response to comply with this collection request: 1 hour and is required to obtain a
benefit. The NRC is required to collect information in the form of a performance progress report and
student service agreement from the grantees for the purpose of monitoring the performance of the grant
award and for the purpose of tracking the students that are funded under the scholarship/fellowship grant
awards program. Send comments regarding burden estimate to the FOIA, Library, and Information
Collections Branch (T-6 A10M), U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by
email to Infocollects.Resource@nrc.gov, and the OMB reviewer at: OMB Office of Information and
Regulatory Affairs, (3150-XXXX), Attn: Desk Officer for the Nuclear Regulatory Commission, 725 17th
Street NW, Washington, DC 20503; email: oira_submission@omb.eop.gov. The NRC may not conduct or
sponsor, and a person is not required to respond to, a collection of information unless the document
requesting or requiring the collection displays a currently valid OMB control number.

NRC Grant Award Number:
Student's Name (Print):
Institution Name (grantee):

This service agreement is required for all students in receipt of Federal funds, funded by the U.S. Nuclear Regulatory
Commission through the grants program, under the grantee (institution listed above). This agreement confirms the student's
obligation for the following:
1. While under this agreement, the student must maintain satisfactory academic progress. (Specifics for each type of
award are below.)
2. Upon completion of the degree or certificate program, the student will serve 6 months of employment in a nuclear
and/or STEM-related job for each partial or full year of academic support. This requirement applies separately to each
grant awarded. This employment may be with nuclear and/or STEM-related industries, State agencies, Department of
Energy laboratories, the NRC or other Federal agencies, or academic in the student's sponsored field of study. The
student has 6 months after graduation to obtain a nuclear and/or STEM-related job. Under the terms of this service
agreement, time spent participating in a cooperative education experience ("co-op") or an internship will not be
considered part of the post-graduation service employment requirement.

MUST CHECK WHICH TYPE OF AWARD IS BEING RECEIVED
Fellowship Award:
• Student must be a United States citizen.
• Student must consistently maintain a course load of at least 12 credit hours per semester or be classified
as a full-time student in good standing (as defined by the recipient institution listed above and in accordance with
the university's policies and practices).
• Student must be matriculated in a graduate degree program that the NRC determines to be sufficiently related to a
nuclear and/or STEM discipline. The recipient institution's grant award must outline both the content of the degree
program as well as the anticipated duration of the program. If the content of the degree program is subject to material
change or the student anticipates needing additional time to complete the program (e.g., to complete a thesis or
dissertation), then the student and the recipient institution must immediately notify the NRC to request approval of
such changes.
• At the time of application, the student must have and maintain a 3.3 GPA (on a 4.0 scale) overall and within a major
for which the fellowship was approved.
Scholarship Award:
• Student must be a United States citizen.
• Students must be junior and senior status (freshmen and sophomores are not eligible)
• Student must consistently maintain a course load of at least 12 credit hours per semester or be classified as a fulltime student in good standing (as defined by the recipient institution listed above and in accordance with the
university's policies and practices).
• Student must be matriculated in a bachelor's degree/major program in a degree program that the NRC determines to
be sufficiently related to a nuclear and/or STEM discipline. The recipient institution's grant award must outline both
the content of the degree program as well as the anticipated duration of the program. If the content of the degree
program is subject to material change or the student anticipates needing additional time to complete the program,
then the student and the recipient institution must immediately notify the NRC to request approval of such changes.
• At the time of application, the student must have and maintain a 3.0 GPA (on a 4.0 scale) overall and within a major
for which the scholarship was approved.
NRC FORM 975 (MM-DD-YYYY)

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NRC FORM 975
(MM-DD-YYYY)

U.S. NUCLEAR REGULATORY COMMISSION

NRC Minority Serving Institutions Grants Program (MSIGP) Service Agreement for Grant
Fellowships, and Scholarships to Colleges, Universities and
Trade/Community Colleges (Continued)

Trade School and Community College Scholarship Award:
• Student must be a United States citizen.
• Student must consistently maintain a course load of at least 12 credit hours per semester or be classified as a fulltime student in good standing (as defined by the recipient institution listed above and in accordance with the
university's policies and practices).
• Student must be matriculated in a Certificate or associate's degree program that the NRC determines to be
sufficiently related to a nuclear and/or STEM discipline. The recipient institution's grant award must outline both the
content of the degree program as well as the anticipated duration of the program.
• If the content of the certificate/degree program is subject to material change or the student anticipates needing
additional time to complete the program, then the student and the recipient institution must immediately notify the
NRC to request approval of such changes.
Citizenship Requirement
Pursuant to Section 243 of the Atomic Energy Act of 1954, as amended, a student supported by a scholarship or fellowship
must be a United States citizen. Students must also have full-time status at the recipient institution (universities, colleges,
community colleges, and trade schools).
Failure to comply with the terms of this Service Agreement
If a student is potentially unable to comply with the terms of this Service Agreement, then the student and the recipient
institution must immediately contact the NRC. The following will be considered a breach of the agreement with the NRC and
require a student to repay the NRC for funds received under this program:
• Student is not a United States citizen;
• Student fails to complete degree program;
• Student fails to consistently maintain required satisfactory academic progress as stated above;
• Student withdraws from the program;
• Student does not gain nuclear and/or STEM-related employment within 6 months after graduation and does not obtain a
waiver from the NRC;
• Student voluntarily leaves the employment of an approved employer before completing the service requirement
(6 months for each partial or full year support).
Some exceptions:
• If a student does not complete the program but does obtain employment in an NRC-approved nuclear and/or STEMrelated job within 6 months of leaving the program, that will satisfy the agreement.
• If a student is working in a nuclear and/or STEM-related position while attending school, the student may request that
the NRC review the employment record to determine whether the service obligation could be reduced.
• If the institution provides funding to a student prior to this service agreement being approved by the NRC, then the
student will not be approved, and the institution will be required to re-pay the funds to the NRC.
Waivers and Delays in Obligation Service
At the discretion of the NRC, waivers and delays in service obligations can be offered for this program. In order to receive
either, a student must submit a request via email to the Grants Program Manager (MSIGP_Resource@nrc.gov).
Waivers:
• If the student requests a waiver based on an inability to obtain employment in a nuclear and/or STEM-related field, the
student must submit at least 6 documents (rejection notices and/or applications submissions) demonstrating a good faith
effort that the student attempted to secure nuclear and/or STEM-related employment but was unable to do so. All
documentation submitted must have the following: name of the company, the position that the student sought, and the
date of application. If any of this information is missing, the NRC will consider the waiver request incomplete and not
accept it for review.
• A waiver request must be in writing (email is acceptable) and include complete written documentation so that the NRC
may review the request.
• A student may request a full/partial waiver of the terms of the service agreement for the following reasons: (1) the student
has encountered medical issues, (2) the student has encountered other hardships, or (3) the student has made serious
attempts to obtain employment in a nuclear and/or STEM-related field but has been unable to do so.
NRC FORM 975 (MM-DD-YYYY)

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U.S. NUCLEAR REGULATORY COMMISSION

NRC FORM 975

(MM-DD-YYYY)

NRC Minority Serving Institutions Grants Program (MSIGP) Service Agreement for
Grant Fellowships, and Scholarships to Colleges, Universities and
Trade/Community Colleges (Continued)

Waivers:
• The NRC will allow documentation to be submitted reflecting dates that are within 6 months prior to the student's
graduation date and 6 months after the student's graduation date - for a total of 1 year. If the documentation is not within
this year- the documentation will not be accepted. Each of the 6 documents must relate to a different position for which
the student applied.
• After reviewing a waiver request, the NRC may determine that it is not feasible for the student to fully comply with the
service agreement. If the NRC makes such a determination, it may waive the service obligation, in whole or in part.
• If the requested waiver is denied, the NRC, under the provisions found in 10 CFR 15.21, will issue to the student a
written invoice for payment. The NRC's determination on a waiver request is final and not subject to appeal.
Delays in service obligations:
• The service obligation period may be delayed allowing the student to continue a subsequent degree program. For
example, if a student receives Federal funding to earn a bachelor's degree, the student may request and be permitted
to delay fulfilling their service obligation upon completion of the subsequent master's degree program. Any such
requests must be made to the NRC before a student enrolls in a subsequent degree program. If a student enrolls in a
subsequent degree program before or without NRC approval and the NRC does not approve the request, the NRC will
not be held liable for any expenses associated with the subsequent degree program. Students only incur a service
obligation to the NRC for funded periods of study.
Repayment of Debt
If the student and/or institution must repay the NRC, the amount owed to the NRC is a valid debt of the Federal government
subject to all laws and provisions governing the administration of the debt. In accordance with Federal regulations, if
payment is not received by the NRC within 30 days from notification of indebtedness, the debt becomes past due and will be
subject to interest, penalties, and administrative charges incurred by the Federal government to service the debt. After 120
days of being past due, the debt will be referred to the Department of the Treasury for collection.
If a single lump sum payment is not possible, the debtor may request an installment repayment agreement. Any such request
must be made in writing and sent to the NRC Office of the Chief Financial Officer (Fees.Resource@nrc.gov), along with a
sufficient justification. An installment repayment agreement can be up to 3 years in length and will include all applicable
interest, penalties, and administrative charges incurred by the Federal government to service the debt. Failure by the debtor
to meet the terms and conditions of the installment agreement will result in the debt being referred to the Department of the
Treasury for collection and subject to the various collection actions administered by the Department of the Treasury. For
additional information, the debtor may contact the NRC Office of the Chief Financial Officer at (301) 415-7554.
Student Contact Information
In accordance with the Privacy Act, the student and the institution agree to provide current student contact information to the
NRC (address, phone, email, and Social Security number, if applicable) and student employment information while the
student remains under the obligated service requirements. The NRC will use this student information to verify appropriate
nuclear and/or STEM-related employment in compliance with this service obligation, and, if necessary, the NRC may use the
contact information to collect a debt. Any changes in student contact or employment information should be immediately
reported to (MSIGP_Resource@nrc.gov).
Certification
By accepting these Federal funds and signing this agreement, the student and the institution certifies that both the student
and the institution have read this agreement and agree to all of the obligations it entails.

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U.S. NUCLEAR REGULATORY COMMISSION

NRC FORM 975

(MM-DD-YYYY)

NRC Minority Serving Institutions Grants Program (MSIGP) Service Agreement for
Grant Fellowships, and Scholarships to Colleges, Universities and
Trade/Community Colleges (Continued)

Signature and Date - Student

Title - University Coordinator:

Signature and Date - University Coordinator

Signature and Date - Approval of the NRC Grants Coordinator

STUDENT CONTACT INFORMATION
Student's Full Name (Please Print):

Student's Permanent Street Address (No P. O. Boxes):

Student's City, State, and Zip Code:

Student's Personal Email (School emails not accepted):

Student's Phone Number:

Student's Major/Degree:

Estimated Graduation Date:

Date that funding will be provided to student:

**Please attach the student's most recent resume with this agreement. Incomplete agreements will not be approved.

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Privacy Act Statement
NRC Form 975
NRC Minority Serving Institutions Grants Program (MSIGP) Service Agreement for
Grant Fellowships, and Scholarships to Colleges, Universities and
Trade/Community Colleges (Continued)
Pursuant to 5 U.S.C. 552a(e)(3), enacted into law by Section 3 of the Privacy Act of 1974 (Public Law 93-579), the following statement
is furnished to individuals who supply information to the U.S. Nuclear Regulatory Commission (NRC) on NRC Form 975, NRC Minority
Serving Institutions Grants Program (MSIGP) Service Agreement for Grant Fellowships, and Scholarships to Colleges, Universities and
Trade/Community Colleges. This information is maintained in a system of records designated as NRC-5 and described at 87 Federal
Register 64262 (October 24, 2022); or the most recent Federal Register publication.
1. AUTHORITY: 42 U.S.C. 16274a, “University Nuclear Leadership Program".
2. PRINCIPAL PURPOSE(S): To monitor the performance of the grant program and for the purpose of tracking the students that are
funded under the scholarship/fellowship grant awards program.
3. ROUTINE USE(S): In addition to the disclosures permitted under subsection (b) of the Privacy Act, the NRC may disclose
information contained in this system of records without the consent of the subject individual if the disclosure is compatible with the
purpose for which the record was collected under the following routine uses:
a.
b.

c.
d.
e.
f.
g.

h.

i.

A record from this system of records may be disclosed as a routine use to that individual's educational institution in order to
monitor the progress of scholarship and fellowship recipients, to ensure compliance with program requirements, to use the
data to demonstrate program effectiveness, and for the educational institution's record-keeping purposes.
A record from this system of records which indicates a violation of civil or criminal law, regulation or order may be referred as
a routine use to a Federal, State, local or foreign agency that has authority to investigate, enforce, implement or prosecute
such laws. Further, a record from this system of records may be disclosed for civil or criminal law or regulatory enforcement
purposes to another agency in response to a written request from that agency's head or an official who has been delegated
such authority;
A record from this system of records may be disclosed as a routine use to a Federal, State, local, or foreign agency to obtain
information relevant to an NRC decision concerning hiring or retaining an employee, letting a contract, or issuing a security
clearance, license, grant or other benefit;
A record from this system of records may be disclosed as a routine use to a Federal, State, local, or foreign agency
requesting a record that is relevant and necessary to its decision on a matter of hiring or retaining an employee, issuing a
security clearance, reporting an investigation of an employee, letting a contract, or issuing a license, grant, or other benefit;
A record from this system of records may be disclosed as a routine use in the course of discovery; in presenting evidence to a
court, magistrate, administrative tribunal, or grand jury or pursuant to a qualifying order from any of those; in alternative
dispute resolution proceedings, such as arbitration or mediation; or in the course of settlement negotiations;
A record from this system of records may be disclosed as a routine use to a Congressional office from the record of an
individual in response to an inquiry from the Congressional office made at the request of that individual;
A record from this system of records may be disclosed as a routine use to NRC-paid experts or consultants, and those under
contract with the NRC on a "need-to-know" basis for a purpose within the scope of the pertinent NRC task. This access will
be granted to an NRC contractor or employee of such contractor by a system manager only after satisfactory justification has
been provided to the system manager.
A record from this system of records may be disclosed as a routine use to appropriate agencies, entities, and persons when
(1) NRC suspects or has confirmed that there has been a breach of the system of records, (2) NRC has determined that as a
result of the suspected or confirmed breach there is a risk of harm to individuals, NRC (including its information systems,
programs, and operations), the Federal Government, or national security; and (3) the disclosure made to such agencies,
entities, and persons is reasonably necessary to assist in connection with NRC efforts to respond to the suspected or
confirmed breach or to prevent, minimize, or remedy such harm; and
A record from this system of records may be disclosed as a routine use to another Federal agency or Federal entity, when the
NRC determines that information from this system of records is reasonably necessary to assist the recipient agency or entity
in (1) responding to a suspected or confirmed breach or (2) preventing, minimizing, or remedying the risk of harm to
individuals, the recipient agency or entity (including its information systems, programs, and operations), the Federal
Government, or national security, resulting from a suspected or confirmed breach.

4. WHETHER DISCLOSURE IS MANDATORY OR VOLUNTARY AND EFFECT ON INDIVIDUAL OF NOT PROVIDING
INFORMATION: Providing the requested information is voluntary. However, if the information is not provided, you may be denied
funding under the scholarship/fellowship grant awards program.
5. NRC CONTACT AND ADDRESS INFORMATON: Senior Grants Administrative Specialist, Office of Nuclear Regulatory Research,
U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001.