Skip to main content

STEP Application


Please fill out the form below as completely as possible. Thank you.

Banner ID (number):
Gender (M or F):
DOB (xx/xx/xxxx):
First Name:
Middle Initial:
Last Name:
Mailing Address:
City:
State:
Zip Code:
Phone (xxx-xxx-xxxx):
E-Mail Address:
Cell Phone (xxx-xxx-xxxx):
Permanent Address:
City:
State:
Zip Code:
Emergency Contact, Name:
Emergency Contact, Phone (xxx-xxx-xxxx):

Current Year in School (Freshman, Sophomore, etc.):
Major(s):
Expected Graduation Date (MM/YYYY):
Cumulative GPA:

I am enrolled full-time (12 credit hrs or more):............ Yes   No

I am a U.S. Citizen, national, refugee or permanent resident:............ Yes   No

I am admitted into my department:............ Yes   No

I am NOT on academic probation:............ Yes   No

I am interested in a Summer Internship:............ Yes   No

I am interested in traveling to regional or national conferences:............ Yes   No