NASA Langley Research Center -- Virginia Space Grant Consortium
Geographic Information Systems (GIS) Internship Program

Spring 2009 Applicant Information Form

Internship Eligibility (at time of placement)

U.S. Citizen and age 16 or older.
Community college, undergraduate, and graduate students with a minimum of 12 credit hours/18 quarter hours completed and a minimum GPA of 3.0/4.0 required.
Internship is also open to motivated high school students who are performing exceptionally in science and technology courses.
Enrolled full-time or part-time with preferred major in Geography, Technology, or Civil Engineering; other majors considered.
Recent graduates must be officially accepted into an official academic program at the next level with plans to enroll the semester immediately following the internship.
Internship placement is contingent upon verificiation of all eligibilty criteria.
This program is a student internship program and is not intended for recent graduates seeking entry-level or part-time employment.

Note: This is not an online application that is submitted through the internet. You can type data into the fields and print the application but you will not be able to save the data.

When you have completed the application, print and forward a signed copy to the Virginia Space Grant Consortium per the guidelines below. You may also print a blank application and complete by hand.

Application Information

Select One:	New Application Renewal Application (current intern)

Semester applying for:

Spring 2009 - application deadline 11/1/2008

Timeframe of availability for the Internship

From

(mm/dd/yyyy)

I. General Data

First Name:
Full Middle Name: (needed for badging)
Last Name:
Maiden Name or any other names used:
Social Security Number:	(last four digits only)
Email:
Confirm Email:
Emergency Contact Name:
Emergency Contact Phone:
Have you had a previous background check?	Yes No
Do you currently or have you ever had secrent clearance?	Yes No
U.S. Citizen:	Yes No

Current Address:
Address 1:
Address 2 (Optional):
City:
State:
Zip Code:	-
Telephone:
Cell Phone:
Congressional District (include state abbrev and district number):	District Search website
Current Address Valid Until:	OR Indefinitely

Permanent Address:
Address 1:
Address 2 (Optional):
City:
State:
Zip Code:	-
Telephone:

Academic Information:
Full Name of Institution:
City:
State:

Have you earned credits at any other colleges or universities?

No Yes

Specify:

Note: If you answered yes, transcripts must be provided from each institution as part of your application package for consideration.

Status as of beginning of Fall Semester 2008:

High School
Undergraduate: Freshman Sophomore Junior Senior

Graduate: Masters Doctorate

Current Degree Seeking:	Associates. B.S./B.A. Joint B.S./M.S. M.S. Ph.D. Other
Explain, if other:

Academic Major:
Are you a full time student?	Yes No

		semester hours
		quarter hours

Cumulative GPA:

/ on a scale of (3.0 or 4.0 or other)

Anticipated graduation date:

II. Additional Information

Describe any related activities that demonstrate your interest/commitment to your chosen discipline. (e.g., memberships in related organizations, hobbies, special skills, honors, awards). Please list and describe your previous participation in any NASA sponsored programs (e.g., internships, research programs, scholarships/fellowships, job shadowing, workshops). Please limit response to 200 words.

Describe any other experiences you think would enhance your application. (e.g., internships, camps, workshops, relevant work history). Please limit response to 200 words.

What do you hope to gain from participating in the NASA Langley -- Virginia Space Grant GIS Internship Program and how might the research experience help you in your chosen discipline/future career? Please limit response to 200 words.

List your relevant coursework that would enhance your internship experience. Please limit response to 200 words.

List computer hardware and software skills. Please limit response to 200 words.

Where did you hear about the NASA - Virginia Space Grant GIS Internship Program? Please limit response to 200 words.

Please add any additional comments below. Please limit response to 200 words.

III. Certification

When the application is complete and ready for transmission, please print a copy and submit it. A signed copy of this certification is required (see below).

I certify that I am a citizen of the United States, or a naturalized citizen, and that all information contained in this NASA Langley - Virginia Space Grant GIS Internship Program application package is accurate.

If Naturalized Citizen, enter U.S. Naturalization number:

________________________________________	___________________________
Signature	Date

Application Requirements

One complete copy of the entire application package must be mailed to:

Virginia Space Grant Consortium
Attention: GIS Intern Coordinator
Old Dominion University Peninsula Center
600 Butler Farm Road, Suite 2200
Hampton, VA 23666

The following items MUST be included in your application package:

*One printed copy of the application, including the certification section with the applicant's orginial signature.
*One letter of reference from a faculty member familiar with your academic work.

*One copy of official or unofficial school transcript listing grades through summer semester of 2008. Include transcripts from each college or university attended. An official transcript will be required prior to final placement.
* Although not required, applicants are encouraged to submit hard-copies of samples of GIS projects with the application package.

No late applications or partial packages will be accepted. No faxed materials will be accepted (no exceptions). We will not be able to accept queries regarding the status of individual applications. You will be notified if you are selected for an interview.

All interns at NASA are required to undergo a background security screening. This screening will take place after selection and before placement in the internship program.

APPLICATIONS MUST BE RECEIVED BY DEADLINE FOR APPROPRIATE SEMESTER. A courier service should be used to mail your application package, or you can hand-deliver the application to VSGC at the address above.

Spring 2009 Semester – January 7 to May 23 (Deadline November 1)