Application
Summer Transportation Institute Program
For High School Students

Name Gender Male Female
Email
Address

School Attending Fall 2013

Parent Name
Address
(if different)
Home Phone

Work Phone

Grade Point Averag: on a 4.0 scale

During the 2013-2014 School Year, I will be in the (check one)
10th Grade 11th Grade 12 th Grade

Shirt Size: S M L XL Other

Career Interests (Check One)
Accounting Environment Engineering
Architecture Law Technology/ Computer Science
Business Marketing Construction
Criminal Justice Scientific Research Transportation

Awards/Achievement/Organizations (attach a list of awards, achievements and organization memberships)


Required Essay: Describe your career objectives, your interest in transportation, and how the Summer Transportation Institute can assist you in reaching your goals.
Your essay must be typed and cannot be more than one page.

Additional Information: Please enclose at least two letters of recommendation and your academic transcript.

Signature & Date (Parent)
Signature & Date (Student)

For SPAM protection, you must type in the number 16 and submit your request:


Essay and Transcript MUST be returned together. Applications with incomplete information will not be processed.
Application deadline: May 3, 2013.

Submit to:

Mr. Gorgui Ndao, Project Director
Center for Student Opportunities
Jenkins Hall, Room 123
Central State University
PO Box 1004
Wilberforce, Ohio 45384-1004
Phone(937) 376-6265
Fax:  (937) 376-6598