STEM INSTITUTE

GROVE SCHOOL OF ENGINEERING
of
THE CITY UNIVERSITY OF NEW YORK
Convent Avenue and 140th Street, Room T-2M15
New York, NY 10031
TEL: (212) 650 – 8172/6190
FAX: (212) 650 – 8139
E-MAIL:stem@ccny.cuny.edu

THE STEM INSTITUTE

The STEM Institute 2013 Application
Note: Incomplete applications WILL NOT be reviewed: Application are extended until Friday, April 12

th

STUDENT INFORMATION

Name: __________________________ _________________________ _______________________
(Last Name)

(First Name)

(Your HS OSI #)

Address: ________________________________________________________ Apt #: _____________
City: ______________________________________ State: ___________ Zip Code: ______________
Social Security #: _____________________ Student Cell Phone #:_____________________________
E-mail Address: _____________________________________________________________________
(Please print)

Date of Birth: ________________ Country of Birth: __________________ Language: _____________
City

Ethnicity:
Citizenship:

Black Non-Hispanic
Asian-Pacific Islander
US Citizen

Hispanic
White Non-Hispanic
American Indian
Other (Please specify): _____________________________

US Permanent Resident

Did you attend The STEM Institute before?

No

Other: ______________

Sex:

F

M

Yes. If Yes, When: Summer of ___________

PARENT INFORMATION

Parent(s)/Guardian’s  Name: ____________________________________________________________
Home Phone #: _________________________ Work Phone #: ________________________________
EDUCATION INFORMATION

Current Grade:

9

10

11

12 Year Entered 9th Grade: __________ Grad. Date: ___________

HS Avg.: __________ Math Avg.: _________ SAT Scores: Verbal: __________ Math: ___________
School Name: _______________________________ Counselor Name: _________________________
School Address: _____________________________ City: ___________ State:______ Zip: _________
Tel: _______________________ Extension: ___________ E-mail:_____________________________
AP Courses Completed: _________________,_______________________,______________________
(See back)

Which GROUP are you applying for? Each group has two classes. Please check ONLY ONE.
Applications with more than one group selected WILL NOT BE REVIEWED!
A.

1. Calculus I (elective HS credit)
2. Engineering Design 10100 (Non-credit)
Pre-requisite: Pre-calculus or a grade of 90 or better in Math B

B.

1. Calculus I (elective HS credit)
2. College Critical Writing & Reading (1 elective HS credit)
Pre-requisite: Pre-calculus or a grade of 90 or better in Math B

C.

1. College Pre-Calculus (1 elective HS credit)
2. General College Physics (1 elective HS credit)
Pre-requisite: A grade of 90 or better in Advanced Algebra or its equivalent

D.

1. College Pre-Calculus (1 elective HS credit)
2. College Critical Writing & Reading (1 elective HS credit), Pre-requisite: Non-ESL
students.
Pre-requisite: A grade of 90 or better in Advanced Algebra or its equivalent.

E.

1. Advanced College Algebra & Trigonometry (1 elective HS credit), Pre-requisite: A 90 or
in general Algebra.
2. MUST check one course:
A.
General College Chemistry (1 elective HS credit), Pre-requisite: HS average of 90
or better
B.
College Critical Writing & Reading (1 elective HS credit), Pre-requisite: Non-ESL
students

F.

1. Engineering 103 (Computer Methods) (Non-credit) &
2. * Select ONLY one Research area.
A.
Electrical Engineering
B.
Civil Engineering C.
C.
Science (Biology, Physics or Chemistry)

Mechanical Engineering

Pre-requites: Calculus I (with a grade of C+ or better) or AP Calculus AB (with a score of 4 or
better).
* Note: Group F is only available for students who meet the additional two conditions:
(1) Be a US Citizenship and (2) Be a Junior (11th) or Senior (12th).
Students who conduct research will receive a small stipend.
REFERENCES: Math and Science teacher recommendations are required. Another person in your
school, church or community is acceptable if your school does not have a math or science teacher.
Please Print:
1. Math Teacher: ______________________ _______________________
Last name
First Name
2. Science Teacher: _____________________ _______________________
Last name

First Name

________________________________
E-mail
________________________________
E-mail

The STEM Institute 2013 Teacher Recommendation Form

Students Name: ________________________________________ Grade: __________ Date: __________________
Please indicate which classes your student is applying for:
1. _____________________________________________

2. ____________________________________________

To the Sponsoring Teacher:
Thank you for your recommendation of the above named student for the 2013 Summer STEM Institute.
Please send the recommendation form, along with your recommendation letter to:
Otto Marte, Assistant Director
Grove School of Engineering/The STEM Institute
Room T- 2M 15
Convent Avenue at 140th Street
New York, NY 10031
212- 650-8172/6190 | fax: 212 - 650-8139
Email: stem@ccny.cuny.edu
URL: http://stem.ccny.cuny.edu

1. Possesses a comfortable knowledge of basic skills and factual information ----------------------------------2. Has ability and desire to follow through on work: able to see a problem through in assigned tasks ---------3. Pursues interests to understand or satisfy curiosity; wants to know how and why. ----------------------------4. Generates questions of his/her own; questions the common, ordinary, or unusual. ----------------------------5. Enjoys the challenge of difficult problems, assignments, issues, and materials. --------------------------------6. Inclined to be independent on his/her own ideas (when appropriate) rather than relying on the structuring of
others.
7. Capable of planning and organizing activities, direct actions, and evaluating his/her own results.-----------8. Requires a minimum of adult direction and attention: possesses skills to facilitate independent work. -----9. Seems self-confident, happy and comfortable in most situations. --------------------------------------------10. Is able to cope with normal frustrations or can adapt to change with minimum difficulty. -----------------11. Able to function effectively as a group member. -------------------------------------------------------------------I2. Is receptive to new tasks or experiences; seems able to take reasonable risks. ---------------------------------

Please check the appropriate box:
I highly recommended the applicant

I recommend the applicant with reservation

I recommend the applicant

I do not recommend the applicant.

Application have been extended until Friday, April 12th
(See Back)

The STEM Institute 2013 Teacher Recommendation Letter
To the Sponsoring Teacher:
Thank you for your recommendation. Please take a moment to write a brief recommendation supporting the
candidacy of this student for participation in this program.
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Teacher’s  Name: _______________________________________________________________ Title: ______________________________
Signature: _________________________________________________________ Phone: _________________________

Application have been extended until Friday, April 12th

The STEM Institute 2013 Teacher Recommendation Form

Students Name: ________________________________________ Grade: __________ Date: __________________
Please indicate which classes your student is applying for:
1. _____________________________________________

2. ____________________________________________

To the Sponsoring Teacher:
Thank you for your recommendation of the above named student for the 2012 Summer STEM Institute.
Please send the recommendation form, along with your recommendation letter to:
Otto Marte, Assistant Director
Grove School of Engineering/ The STEM Institute
Room T-2M 15
Convent Avenue at 140th Street
New York, NY 10031
212- 650-8172/6190 | fax: 212 - 650-8139
Email: stem@ccny.cuny.edu
URL: http://stem.ccny.cuny.edu

1. Possesses a comfortable knowledge of basic skills and factual information ----------------------------------2. Has ability and desire to follow through on work: able to see a problem through in assigned tasks ---------3. Pursues interests to understand or satisfy curiosity; wants to know how and why. ----------------------------4. Generates questions of his/her own; questions the common, ordinary, or unusual. ----------------------------5. Enjoys the challenge of difficult problems, assignments, issues, and materials. --------------------------------6. Inclined to be independent on his/her own ideas (when appropriate) rather than relying on the structuring of
others.
7. Capable of planning and organizing activities, direct actions, and evaluating his/her own results.-----------8. Requires a minimum of adult direction and attention: possesses skills to facilitate independent work. -----9. Seems self-confident, happy and comfortable in most situations. --------------------------------------------10. Is able to cope with normal frustrations or can adapt to change with minimum difficulty. -----------------11. Able to function effectively as a group member. -------------------------------------------------------------------I2. Is receptive to new tasks or experiences; seems able to take reasonable risks. ---------------------------------

Please check the appropriate box:
I highly recommended the applicant

I recommend the applicant with reservation

I recommend the applicant

I do not recommend the applicant.

Application have been extended until Friday, April 12th
(See Back)

The STEM Institute 2013 Teacher Recommendation Letter
To the Sponsoring Teacher:
Thank you for your recommendation. Please take a moment to write a brief recommendation supporting the
candidacy of this student for participation in this program.
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Teacher’s  Name: _______________________________________________________________ Title: ______________________________
Signature: _________________________________________________________ Phone: _________________________

Application have been extended until Friday, April 12th

Grove School of Engineering
THE CITY COLLEGE
of
THE CITY UNIVERSITY OF NEW YORK
Convent Avenue and 140th Street, RM 2M-15
New York, NY 10031
TEL: (212) 650 – 8172/6190
FAX: (212) 650 – 8139
E-MAIL: stem@ccny.cuny.edu

STEM INSTITUTE

Official Transcript Request
Students: Please ask your parent or guardian to fill out this form, deliver it to your school
counselor, make arrangements for pick up and mailing or for your school to mail a copy of your
official transcript to the program address above. Thank you.

Dear School Counselor,
My son/daughter ___________________________________ needs to submit an official transcript to
the 2013 The STEM Institute.
Would you please arrange to provide him/her with the official transcript or send it directly to the above
address. Thank you.

Sincerely,
____________________________________________
Signature of Parent/Guardian

_______________________
Date

Application have been extended until Friday, April 12th