San Jose State University-McN-Application Form

The McNair Scholars Program is a federally-funded TRIO program. The Ronald E. McNair Post Baccalaureate Achievement Program at San José State University (SJSU) is an exciting effort designed to encourage low-income individuals who are first-generation college students and/or underrepresented in graduate education to pursue doctoral study. All participants must meet specific eligibility criteria as determined by the U.S. Department of Education.

Eligibility must be properly established for selection. For more information, please visit: https://www.sjsu.edu/mcnair/

In order to be considered for admission to the McNair Scholars Program, a complete application packet must be submitted.

PLEASE NOTE: Once you begin the online application form, you must be ready to attach the items below. Any incomplete online application cannot be saved on this Google form.

SEE STEPS BELOW:

1) FOR THE ONLINE APPLICATION FORM - APPLICANT INFORMATION. Please provide all the appropriate information requested on this form. This information is vital for the purpose of determining your eligibility for the McNair Scholars Program according to federal guidelines.

2) FOR THE ONLINE APPLICATION FORM - SUPPORTING DOCUMENTS. Please include all the following documentation with your online application:

A) Transcript(s): official transcript(s) from your previous institution(s), if attended. By submitting this form, you authorize the McNair Scholars Program to obtain your official SJSU transcripts for the program’s evaluation purposes. Official transcript(s) from Community College or other universities attended are needed, if applicable. Please upload official transcripts onto this form or request PDF versions from the institution(s) previously attended and send to the McNair Scholars Program via email at mcnair-program@sjsu.edu.

B) Family Income Verification: Documentation of family income is required for the purpose of determining your eligibility for the McNair Scholars Program. Proof of family income must be submitted with this online application form. Your family income may be verified with a signed copy of your and/or your parents’ most recent federal income tax forms from the IRS by visiting: www.IRS.gov Please only submit the 2021 IRS 1040, 1040A, or 1040 EZ tax form. Please upload the tax forms via image or PDF format on this application. Additionally, prepare to submit a copy of your FAFSA Student Aid Report (SAR) found on studentaid.gov and a copy of your Financial Aid Award Notice for the 2022-2023 academic year from your MySJSU.

C) Personal Statement: Your personal statement is very important to the selection
process. The personal statement should be no more than 3-pages in length, typed, doublespaced, and include page numbers. Focus on your academic and career objectives. The committee would like to know about your research and career interests and why you feel obtaining a doctorate is essential in pursuing those interests. You should also address how the McNair Scholars Program will help to reach your academic goals.

D) Research Experience Statement: Describe any previous research experience or honors you have received to date.

E) Attach a photo of yourself. (For staff purposes only)

F) Optional: Resume or CV

3) AFTER COMPLETING THE ONLINE APPLICATION - The Recommendations: Two
recommendations are required and should be from any faculty/professors (even transferred institution). Recommendations should be emailed from your recommenders. An optional third letter may be from an employer, counselor, advisor, or another individual who can attest to your academic or work potential, or your personal attributes. All letter recommendations should be submitted by the application deadline.

Please provide the following PDF recommendation form to your recommenders:
https://www.sjsu.edu/mcnair/docs/2020%20Letter%20of%20Recomendation%20Form%20-%20McNair%20Scholars%20Application%20.pdf

Professors can send letters via email to the McNair Scholars Program general email -mcnair-program@sjsu.edu.

4) AFTER COMPLETING THE ONLINE APPLICATION: You will receive an email from
DocuSign in a few days requesting signatures to finalize your online application.

For more information, please contact:

McNair Program Office: 408-924-2540

Maria E. Cruz, PhD Taylor-Dawn Francis, MA
Director Program Coordinator
maria.cruz@sjsu.edu taylor-dawn.francis@sjsu.edu

Statement of Confidentiality: The information requested in this application is for the
purpose of determining the applicant’s eligibility for the McNair Scholars Program.
Information received is treated confidentially.

Applicant Information

Name*

First NameMiddle NameLast Name

Gender

ManWomanGenderqueer/Non-BinaryOther - Please specify in next question

Preferred Pronoun(s)

Local Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Permanent Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone

(999)999-9999

Telephone

(999)999-9999

Email Address #1*

example@example.com

Email Address #2

example@example.com

Date of Birth*

mm-dd-yyyy

Social Security Number (must include - your SSN will be used to track your progress for a minimum of 10 years post-graduation for the Federal Department of Education Annual Performance Reports.)*

999-99-9999

Student ID #*

Citizenship: (If you are a Permanent Resident or a Citizen who was born outside of the United States, please provide a copy of USCIS Documentation at the time of interviews.)*

CitizenPermanent Resident

Ethnic Heritage:*

Please specify from the previous question if applicable; otherwise, type N/A

How did you hear about the McNair Scholars Program?

Please attach a photo of yourself (For staff purposes only)

Financial Information

For financial aid purposes, are you considered dependent or independent? If unsure, please visit: https://www.sjsu.edu/faso/process/dependent-vsindependent.php*

If dependent: What is the size of your parent's household, including yourself?(please answer numerically) If not dependent, type N/A*

If dependent: Did your parent(s) file a federal income tax return for the previous year?*

YesNoNot dependent

3. From the previous question: If answered yes, what was their taxable income for the previous year? (Line 43 on the IRS form 1040, line 27 on the IRS form 1040A,line 6 on IRS form 1040 EZ). Type "0" if taxes were not filed/not dependent*

If independent: What is the size of your household, including yourself, spouse, and/or other dependents? (please answer numerically) If not independent, type N/A*

If independent: Did you file a federal income return for the previous year?*

YesNoNot independent

3. From the previous question: If answered yes, what was your taxable income for the previous year? (Line 43 on the IRS form 1040, line 27 on the IRS form 1040A,line 6 on IRS form 1040 EZ). Type "0" if taxes were not filed/not independent*

Are you Federal Pell Grant-eligible (FAFSA)?

YesNo

https://studentaid.gov/understand-aid/types/grants/pell

Please attach your (if independent) or parents (if dependent) most recent IRS Tax Form: 1040A, 1040 EZ or 1040. For examples, please visit: https://www.irs.gov/forms-instructions*

Please attach a copy of your most recent FAFSA Student Aid Report (SAR). For instructions on how to retrieve your FAFSA SAR, please visit: https://studentaid.gov/help/view-sar*

Please attach a copy of your Financial Aid Award Notice for the 2022-2023 academic year from your My SJSU. For instructions on how to obtain your Financial Aid Award Notice through My SJSU, please visit: https://www.sjsu.edu/faso/Applying/Seven_Steps_To_Financial_Aid/five/*

Educational Attainment of Mother: (highest grade completed)*

Educational Attainment of Mother: College Degree earned, if any*

BachelorsMastersDoctorateNo 4-year college degree

If your Mother received a BA, MA, or PhD which country was it earned in? If a 4-year college degree was not earned, type N/A*

Educational Attainment of Father: (highest grade completed)*

Educational Attainment of Father: College degree earned, if any*

BachelorMastersDoctorateNo 4-year college degree

If your Father received a BA, MA, or PhD which country was it earned in? If a 4-year college degree was not earned, type N/A*

Before the age of 18, with whom did you regularly reside and receive support from?*

Mother OnlyFather OnlyBothOther

First College Entry Date (Community College or University)*

mm-dd-yyyy

Anticipated number of units completed after Spring

Projected graduation date?*

mm-dd-yyyy

Major?*

Current SJSU GPA:*

GPA in your Major:*

Transfer Only: If you do not have an SJSU GPA, enter your transfer GPA (a copy of your Spring Grade Report must be submitted in order to verify your SJSU GPA after the Spring semester) If not a transfer student, type N/A

Transfers Only: Attach Community College transcripts or send via PDF to mcnair-program@sjsu.edu

What is your projected date of entrance into graduate school?

mm-dd-yyyy

In what field do you plan to obtain a doctoral degree?

Research/Additional Experience

Please provide any supplemental information you wish to have considered:

Describe your research experience, if any, including dates and advisor/primary investigator.*

List any academic honors you have received at the college level.*

Research Interest

Please state your research interest or question that will be the basis of your McNair Project:*

Provide the names of two San José State Faculty Members who you feel would be ideal mentors for the research project provided above. ("I have already discussed this project with this professor.")*

Letters of Recommendation

Two letters of recommendation from faculty members/professors (any institution) are
required. See Recommendation Format:
https://www.sjsu.edu/mcnair/docs/McNair%20Scholars%20Program%20Recommendation%20Form.pdf

Your recommendations should address how your academic preparation and interests make you well suited for the program. If you are unable to obtain both letters from faculty you may submit one letter from a graduate school instructor or someone who can comment on your academic performance and research potential. Keep in mind that this is a very important part of the application.

1) Recommender's Name, Telephone & Email

2) Recommender's Name, Telephone & Email

I am aware I must communicate with my recommenders and send them the
following link to my in order to complete the letter of recommendation part of the
application:

https://www.sjsu.edu/mcnair/docs/McNair%20Scholars%20Program%20Recommendation%20Form.pdf (Letter of recommendations are due at the time of the application deadline and Recommenders must email: The McNair Scholars Program at mcnairprogram@sjsu.edu)

Mark only one oval.

Yes, I understand

Contact Information

Please provide the names and permanent addresses of three people who will know how to reach you in the future (e.g. grandparents or other relatives).

1. Name of relative/Permanent Contact, address (include city, state, & zip code),telephone, & email or cell phone

2. Name of relative/Permanent Contact, address (include city, state, & zip code),telephone, & email or cell phone

3. Name of relative/Permanent Contact, address (include city, state, & zip code),telephone, & email or cell phone

Personal Statement

The selection committee will pay close attention to your personal statement. This statement should be no longer than 3 pages and focus on your academic and career objectives. The committee would like to know about your research and career interests and why you feel obtaining a doctorate is essential in pursuing those interests. You should also address how the McNair Scholars Program will help to reach your academic goals.

Please attach a typed copy of your personal statement*

Optional Resume or CV:

Signatures

After this application is submitted, you will receive an email from DocuSign requesting electronic signatures in a few days. For any further questions, please email: Taylor-Dawn Francis (McNair Scholars Coordinator) at taylor-dawn.francis@sjsu.edu.

SJSU McNair Scholars Program Application 2024