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Scholarship Award Survey
Please take a few minutes to answer the questions below.
Your answers will be used by G.E.M. Environmental staff to learn more about our scholarship recipients and identify what improvements we can make for the future.

* Indicates required field

Name *

First

Last

Email *

How did you hear about G.E.M. Environmental and this scholarship opportunity? *

My major/area of focus is: *

Aeronautics Archaeology/Anthropology Biology Earth Science Engineering Geology Math Technology Space science Other science field

If other science field, please explain here: *

I am: *

A recent college graduate Still in school

I used/plan to use my scholarship funding from G.E.M. Environmental for: *

Books/School Supplies Field Experience/Travel Student loan payment Other

If other, please explain: *

I identify as a: *

Male Female Other

What is your age? *

18-20 20-25 25-30 30-35 Over 35

Are you/were you a veteran? *

Yes No

I describe myself as: *

African American Asian Caucasion/White Chinese Filipino Hawaiian Hispanic/Latino Indian Japanese Native American Pacific Islander Other Asian Other

Select one or multiple responses.

If you identify as other in the above category, will you please share what you describe youself as? *

What kind of housing do you currently live in? *

Campus housing/dorm Group home Homeless Owned home Rented home or apartment Reservation Shelter With family or friends Other

If you selected other in the above category, will you please share where you live? *

What is the highest level of education completed by your parents (step parents or guardians, if applicable): *

Both have their high school diploma One, or both, attended high school, but did not finish Both attended college, but did not complete One, or both, completed a college degree (associates degree and/or bachelors degree) One, or both, completed a professional degree (masters degree, PhD, or other professional degree) Both did not attend school Don't know/Unsure

If one or both of your parents/guardians completed a college degree, what was their major? *

This question helps us determine if you're the first, or one of the first people in your family to work on or complete a STEM degree.

What is your household income? *

Less than $10,000 $10,001 - $25,000 $25,001 - $40,000 $40,001 - $70,000 $70,001 - $100,000 Greater than $100,000

Did a guest science speaker ever come to one of your classes (K-12) that inspired you? *

Yes No Don't Remember

If a guest science speaker spoke to one of your classes, how were you inspired? Do you remember his/her name? *

Anything else you want to add (compliment, share a success story, concern, or question): *

If you did not answer any of the questions above, or only some of them, please explain why you chose not to answer so that we may improve our survey: *

I understand that my identity will be completely anonymous and that the information I share here will be used in scholarship demographic data reports and other media to share how scholarship funding is/will be used and who was awarded scholarships in our program: *

I agree

Submit

We value you taking the time to complete the above demographic survey.
Please consider sharing your success story, which will be featured on our blog and social media to promote your work.
Click here for more information and instructions on how to submit your success story.

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