McNair Scholar Program Application Form

Applicant Information

Full Legal Name *

First Middle Last

Student ID Number *

Email Address *

Current Address *

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

Permanent Address *

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

Phone *

Date of Birth *

Place of Birth *

Citizenship (check one) *

U.S. Citizen
Permanent Resident

Do you identify ethnically as Hispanic/Latino? *

Yes
No

How do you identify racially? (Check all that apply, you must check at least one) *

American Indian/Alaskan Native
Asian
Black/African American
White
Native Hawaiian/Pacific Islander
Other

What is your primary language? *

What other languages do you speak? *

Financial Information

On your FAFSA, are you an independent student? *

If Yes, complete Your Taxable Income below. If No, complete Your Parents' Taxable Income AND Your Taxable Income below.

Yes
No

Your Taxable Income (approximate) on your most recent tax return (if you are independent)

How many dependents did you claim? (if you are independent)

Your Parents' Taxable Income (approximate) on most recent Tax Return (if you are dependent)

How many dependents did your parents claim? (If you are dependent)

Do you give the McNair Scholars Program permission to verify your income through the Boise State Financial Aid office? *

Yes
No

How many hours do you work per week on average? (If not presently employed, state "zero") *

Family Information

Father's/Guardian's Legal Name *

First Last

Highest level of education earned by your father *

8th grade or lower
9th - 12th grade
High school graduate
Some college
Bachelor's degree
Master's degree
Doctorate

Mother's/Guardian's Legal Name *

First Last

Highest level of education earned by your mother *

8th grade or lower
9th - 12th grade
High school graduate
Some college
Bachelor's degree
Master's degree
Doctorate

Please provide the name and permanent address of one person who will know how to contact you in the future:

Name of relative or permanent contact *

First Last

Address of relative or permanent contact *

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

Phone *

Educational Information

Are you currently enrolled at Boise State? *

Yes
No

Current major(s) *

Degree sought *

B.A.
B.S.

Expected graduation date (mm/yy) *

Total credits completed *

Current class standing *

Sophomore
Junior
Senior

Cumulative GPA *

Last semester GPA *

Are you a transfer student to Boise State? *

Yes
No

If yes, from which institution?

Date of first enrollment at Boise State (mm/yy) *

Date you first enrolled in college (mm/yy) *

Name of your academic advisor *

First Last

When did you last meet with your advisor? (mm/yy) *

Which fields of graduate study interest you? *

Highest degree objective *

How did you learn about our program? *

Classroom visit
Faculty
Fellow student
McNair scholar
McNair staff
Open house
TRIO staff
Other

Have you participated in any of the following federal programs? *

TRIO Educational Talent Search
TRIO Upward Bound
TRIO EOC
TRIO Student Success Program (SSS)
CAMP
NA