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CATALYST Application

The CATALYST Academy seeks to advance diversity in engineering and especially encourages the application of members of groups severely underrepresented (African American, Latino/a, or Native American) in the fields of science, technology, engineering and math. To apply, use the CATALYST Academy Online Application located further down on this page.

ELIGIBILITY

Applicants must be rising sophomores, juniors, or seniors.

All applicants must have a minimum cumulative GPA of 3.0 on a 4.0 scale.

All applicants are required to submit the following supporting documents listed below:

Completed CATALYST Academy Recommendation Form from a math or science teacher or a high school counselor
Official high school transcript
High school profile (may be obtained from your high school guidance office)

Submit the completed required supporting documents, to the following address:

The CATALYST Academy
Diversity Programs in Engineering
146 Olin Hall
Cornell University
Ithaca, NY 14853

The submission and postmark deadline for online applications along with the required supporting documents is 11:59 p.m., Monday, March 2, 2009.

TUITION

Tuition for the 2009 CATALYST Academy, which includes room and board, is $1200 and payable only after notification of acceptance.

Financial assistance for tuition and/or travel is available based upon demonstrated need. To apply for financial assistance, please complete and submit the CATALYST Academy Application for Financial Assistance. Financial assistance awards will be included with the notification of acceptance.

The CATALYST Academy Online Application

First Name:

Last Name:

Nick Name::

Gender:

Male

Female

Birth Date:

mm/dd/yy

Home Address:

City:

State:

Zip Code:

Country:

Home Phone:

Cell Phone:

E-mail:

First Language, if other than English:

(Optional)

Primary Language at Home:

Optional - Ethnicity (check all that apply):

African American/African/Black

Asian

Caucasian/White

Latino(a)

Mexican/Chicano(a)

PuertoRican

Native American/Alaska Native

Other

NativeHawaiian/PacificIslander

If Asian:

What are the countries of your family's origin? (optional)

If Native American/Alaskan Native:

What is your Tribal Affiliation? (optional)

If Ethnicity Other:

Graduation Year:

Cumulative GPA:

Name of High School:

School Address:

School City:

School State:

School Zip Code:

School Country (if outside of the United States):

Math Courses (high school & college level):

Algebra I

Sequential Math I

Algebra II

Sequential Math II

Geometry

Sequential Math III

Pre-Calculus

Calculus

AP Calculus AB

AP Calculus BC

Statistics

AP Statistics

Trigonometry

Select all that apply.

Math Other:

List any other math courses you may have taken, not listed above.

Science Courses (high school & college level):

Earth Science

Life Science

Biology

AP Biology

Chemistry

AP Chemistry

Physics

AP Physics

Environmental Science

AP Environmental Science

Computer Science

Physical Science

Integrated Science I

Mechanics

Integrated Science II

Robotics

Please select all that apply.

Science Other:

List any other science courses you may have taken, not listed above.

Scholastic Distinctions or Honors:

Briefly list any scholastic distinctions or honors you have earned since 9th grade. If none, please put N/A.

Enrichment or Summer Academic Programs:

Please list or describe, any enrichment or summer academic programs you have been involved with since 9th grade. If none, please put N/A.

9th Grade Activities:

List all 9th grade activities, positions held, and/or honors won. If none, put N/A.

10th Grade Activities:

List all 10th grade activities, positions held, and/or honors won. If none, put N/A.

11th Grade Activities:

List all 11th grade activities, positions held, and/or honors won. If none, put N/A.

Parents' Martial Status (relative to each other):

Never Married

Married

Widowed

Separated

Divorced

Parent/Guardian 1:

Mother

Father

Legal Guardian

Full Name:

Parent/Guardian 1-Living?:

Yes

Home Address if different than yours:

Parent/Guardian 1-Home Phone:

If none, please indicate.

Parent/Guardian 1-Cell Phone:

If none, please indicate.

Parent/Guardian 1-eMail Address:

Parent/Guardian 1-Occupation:

Parent/Guardian 1-Name of Employer:

Parent/Guardian 1-Education:

Parent/Guardian 1-College (if any):

Please list the name(s) of any college(s) attended.

Parent/Guardian 1-Degree Year:

Parent/Guardian 1 Graduate School Degree:

ie DDS, DVM, MBA, MEng, MD, MSW, etc.

Parent/Guardian 1-Graduate School (if any):

Please list the name(s) of any Graduate School(s) attended.

Parent/Graduate 1-Graduate Degree Year:

Parent/Guardian 2:

Mother

Father

Legal Guardian

None

Parent/Guardian 2-Full Name:

Parent/Guardian 2-Living?:

Yes

Parent/Guardian 2-Address if different than yours:

Parent/Guardian 2-Home Phone:

If none, please indicate.

Parent/Guardian 2-Cell Phone:

If none, please indicate.

Parent/Guardian 2-eMail Address:

Parent/Guardian 2-Occupation:

Parent/Guardian 2-Employer:

Parent/Guardian 2 - Education:

Parent/Guardian 2- College if any:

Parent/Guardian 2- Degree Year:

Parent/Guardian 2-Graduate School:

Please list the name(s) of any Graduate School(s) attended.

Parent/Guardian 2 Graduate School Degree:

ie DDS, DVM, MBA, MEng, MD, MSW, etc.

Parent Guardian 2 Graduate Degree Year:

How many members are in your household?:

Is your household income under $60,000?:

Yes

Do you qualify for free or reduced lunch?:

Yes

Siblings or parents that are Cornell alumni?:

Yes

If yes:

Please provide relationship(s) to you, name(s) and graduation year(s).

Siblings that are CATALYST Academy alumni?:

Yes

If Yes:

Please provide name(s) and program year(s)

How did you hear about the CATALYST Academy?:

Brochure/Poster

Guidance Counselor

Teacher

Publication

Internet

Cornell Admissions Counselor

Cornell DPE staff member

CATALYST Academy alumna/alumnus

Cornell alumna/alumnus

Check all that apply.

If Internet:

Please provide the name or description of the website.

If Publication:

Please provide the name of the publication.

If Cornell alumna/alumnus:

Please list name and graduation year of alumna/alumnus.

If CATALYST Academy alumna/alumnus:

Please list name(s) and program year of alumna/alumnus.

Other, Please Specify:

Essay should be no more than 500 words and explains all the following:

- Why you want to participate in this program.
- What you hope to gain from the experience.
- What interests you about engineering.
- What thoughts you have about your future career.

I certify that all information submitted for my CATALYST Academy application package is my own work, factually true and honestly presented. I understand that I may be subject to an admission revocation if any of this certified information is found to be false.

Signature:

Type your full name to provide an electronic signature

Date Signed:

Please call 607.255.6403 or e-mail dlm45@cornell.edu to confirm that your application has ben received.

Application Package Checklist

Use this as a checklist to ensure that your application package is complete. Check off each item as you put it in one envelope. The Diversity Programs in Engineering office will not review incomplete application packages.

Completed CATALYST Academy Application form and essay
Completed CATALYST Recommendation Form from a math or science teacher or a high school counselor in a sealed envelope with the signature of the recommender across the seal.
Official high school transcript
High school profile

Make Sure:

Your full name is typed or printed clearly on every item in your application package.
You have made copies of your completed application and essay for your own records.

DIVERSITY

Diversity Programs Office

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