Name:
Address:
City, ST Zip:
Email Address: Phone:
Expected Graduation Date: GPA:
CU ID Number:
Undergraduate Class: please select Freshman Sophomore Junior Senior Graduate Student: please select Masters Doctor
Major: please select General Engineering Bioengineering Biosystems Engineering Chemical Engineering Chemistry Civil Engineering Computer Engineering Computer Information Systems Computer Science Electrical Engineering Environmental Engineering Geological Sciences Industrial Engineering Materials Science & Engineering Mathematical Sciences Mechanical Engineering Physics & Astronomy or Other:
PEER/WISE Program Activities (Please write the dates you were active by activity):
Favorite PEER/WISE Memory:
What has PEER/WISE meant to you and how do you plan to continue PEER/WISE efforts in the future?
What would this scholarship mean to you?
How do you plan to use your Clemson degree after graduation?