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| Please complete the entire form below. All fields in Red are required: |
| First Name: |
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Last Name: |
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| M.I. |
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| Home Address: |
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| City: |
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State/Province: |
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| ZIP/Postal Code: |
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Country: |
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| Home Phone: |
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Emergency Phone: |
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| Gender: |
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Date of Birth
(mm/dd/yyyy): |
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| E-mail Address: |
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| PSU Admissions Login ID: |
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(e.g., ABC1234) If you do not have a PSU Admissions Login ID, please click here to go to the Admissions website. Once you obtain the Admissions Login ID, enter it in this field. |
| I am currently in:
th.
grade
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Ethnicity: |
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| Ethnicity (Other): |
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Parent/Guardian Name: |
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| High School Name: |
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| High School Address: |
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| High School City: |
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High School State/Province: |
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| High School ZIP/Postal Code: |
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| Guidance Counselor's Name: |
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Guidance Counselor Phone: |
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| Expected Graduation Date:
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| Have you participated in the VIEW program before?
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| If Yes, what was the year you participated?
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| T-Shirt Size: |
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| Essay: |
What type of engineer do you aspire to be and why? Explain why in a one page typed essay. (Aerospace, Agricultural and Biological, Architectural, Bioengineering, Chemical, Civil and Environmental, Computer Engineering, Computer Science, Electrical, Engineering Science, Industrial and Manufacturing, Mechanical, Nuclear, and Earth and Mineral Science)
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By clicking on the Submit Application button below I acknowledge that the information entered above is true and accurate to the best of my knowledge.
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