The STEM Forward Scholarship Application 

For Southeastern WIsconsin High School Seniors

Application Deadline: Monday, April 17, 2017

STEM Forward will award one deserving, high school senior a $2,000 scholarship to pursue a program in science, technology, engineering and/or math (STEM) at a two- or four-year Wisconsin technical college or university. The winner will be announced before May 31, 2017.

Qualified applicants MUST meet the following criteria: 
- Be a graduating high school senior, residing in the Milwaukee 7. (Milwaukee, Waukesha, Ozaukee, Washington, Racine, Kenosha or Walworth counties)
- Have a 3.0 GPA or higher.
- Attend a Wisconsin two-year or four-year technical college or university in the fall of 2017, and pursue a STEM program.
- Your school and/or school district must participate in at least one STEM Forward program (Ex: Future City Competition, Day of Engineering, Rube Goldberg Machine Contest) for the past two years OR you must have participated in one STEM Forward program in the past. Click here to view a list of eligible districts and/or schools.
- You cannot be a child of a STEM Forward board member and/or staff member.

*** At least one of your listed references MUST be a STEM teacher or mentor.

Please read this entire application before proceeding to ensure that you are prepared and have all the required information to complete this form. You will not be able to save your application and edit it later on. STEM Forward will be contacting references of selected finalists. 

Submitting an online application is preferred, but paper copies are available by request. If needed, please contact Chantel Kuczmarski at 414.221.7720 or ckuczmarski@stemforward.org

Student's Name *
Student's Name
Home Address *
Home Address
Phone Number *
Phone Number
Parent's Name or Legal Guardian
Parent's Name or Legal Guardian
Parent's Phone Number *
Parent's Phone Number
High School Address *
High School Address
High School Phone Number *
High School Phone Number
Name of High School Guidance Counselor *
Name of High School Guidance Counselor
Phone Number of High School Guidance Counselor *
Phone Number of High School Guidance Counselor
Name of Reference 1 (Please include a school administrator, teacher, mentor, counselor, employer or coach.) *At least one reference MUST be a STEM teacher and/or mentor. *
Name of Reference 1 (Please include a school administrator, teacher, mentor, counselor, employer or coach.) *At least one reference MUST be a STEM teacher and/or mentor.
Phone Number for Reference 1 *
Phone Number for Reference 1
Name of Reference 2 (Please include a school administrator, teacher, mentor, counselor, employer or coach.) *At least one reference MUST be a STEM teacher and/or mentor. *
Name of Reference 2 (Please include a school administrator, teacher, mentor, counselor, employer or coach.) *At least one reference MUST be a STEM teacher and/or mentor.
Phone Number for Reference 2 *
Phone Number for Reference 2
I hereby authorize review of my student file for information relevant to scholarship selection. Further, if I am selected to receive a STEM Forward scholarship, I agree to allow STEM Forward to release information relevant to my selection for publicity purposes. *
Applicant's Signature *
Applicant's Signature
Parent/Guardian's Signature *
Parent/Guardian's Signature

The scholarship recipient will be recognized at the STEM Forward Invitation Golf Outing Luncheon on Thursday, August 17, 2017 at Morningstar Golf Course in Waukesha. The $2,000 check will be presented to the Wisconsin college or university that the student is enrolled in. STEM Forward's scholarship program relies on contributions and proceeds from the annual outing. 

STEM Forward does not discriminate on the basis of race, national or ethnic origin, religion, age, sex, marital status, or handicap in the administration of its policies, activities, membership selection or scholarship programs.