COEN Organization Support Application

Contact Information

Name(Required)

First Last

Date of Birth(Required)

Student Identification Number(Required)

Preferred Email(Required)

Enter Email Confirm Email

Alternate Email

Enter Email Confirm Email

Permanent Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Academic Information

Fall 2023 Primary Institution(Required)

Currently attend or previously attended community college?

If Other, please list the institution's name here:

Major (Declared)(Required)

If Other, please explain:

Is Your FAFSA Updated?(Required)

Overall (Cumulative) GPA (As of Spring 2023)(Required)

Enrolled as a full-time student for Fall 2023 (12 or more total credit hours)?(Required)

Upload an Unofficial Transcript (pdf)(Required)

Max. file size: 10 MB.

What skills, characteristics, or traits do you have that you believe will make you a good computer scientist or engineer? (300 Words Max)(Required)

Demographic Information

Applicants will not be chosen nor excluded from participation on the basis of race, color, national origin, sex, sexual orientation, gender identity, disability, protected veteran status, limited English proficiency, or any other status protected under applicable federal, state or local law.

Gender Identity

Are you Hispanic or Latino(a)?

Yes

Prefer not to answer

Race/Ethnicity

How would you describe yourself? Please select all that apply.

African American/Black

Asian/Asian American

Southwest Asian or North African

Hispanic American/Latino(a)

Native American/Native Alaskan

White/Caucasian

Two or More Races/Ethnicities

Other

Prefer not to answer

Do you identify as a person with a disability

Yes, I identify as a person with a disability

No, I do not identify as a person with a disability

I do not wish to disclose

Highest degree obtained by parent/guardian(s)

COEN Organization Support Application

CAES Scholars Program Application Form

Contact Information

Academic Information

Demographic Information

COEN Advising Office