First Name
Last Name
UCSB e-mail
Personal e-mail
Phone
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Status
Freshman
Sophomore
Junior
Senior
Major - Please be sure you select the major that corresponds to the
college you are in and the
degree you are pursuing. College of Creative Studies majors are listed first, followed by College of Engineering majors, followed by College of Letters and Science majors. DO NOT include minors.
When did you start your graduate program?
When did you start your postdoc?
When do you expect to complete your graduate program? Note: If this is your final quarter at UCSB, you must be able to complete the post-travel/experience presentation and summary write up before you leave.
When do you expect to complete your postdoc? Note: If this is your final quarter at UCSB, you must be able to complete the post-travel/experience presentation and summary write up before you leave.
Which department is home to the graduate program you are enrolled in?
Dates of Travel/Experience - approximate dates are OK
Start Date
End Date
Do you need to travel to participate in this experience? We are only able to fund travel to certain states within the US.
Yes, and my travel is within the US
No
What state will you travel to? Please note that if the state you need to travel to is not listed, then we are unfortunately not able to fund your trip.
What country will you travel to?
Please provide the name of the opportunity for which you are applying.
Please write a statement (500 words max) that describes:
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Your goals after graduation
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How this opportunity will help you build the skills or knowledge to help you achieve these goals
If I receive this grant, I acknowledge that I will submit an experience summary (300 words or fewer) and provide a post-travel/experience review via an "IPS Insights" video or a 5-min Meet & Eat presentation.
If I receive this grant, I acknowledge that I will submit an experience summary (150 words or fewer).
If I receive this grant, I acknowledge that I will submit a photo from the event and an experience summary (300 words or fewer).
I agree to the above statement
Please provide an estimated budget for your proposed opportunity in the questions below. If a particular expense is not applicable, or you are not sure of an expense at this time, simply put N/A in that field. We will follow up with you if needed. Note: A maximum of $1,000 will be awarded from the UCSB SACNAS Career Pathways Program program.
Travel and Transportation (airfare, mileage, etc.)
Lodging
Registration Fees
Meals/Food
Total Anticipated Cost of the Experience
Total Requested from UCSB SACNAS Career Pathways Program
Please describe (150 words max) any additional funding you have sought out, applied for, or been awarded for this opportunity (e.g., conference or professional society scholarships, lab or advisor funds, outside grants or fellowships). If you have not pursued any additional funding, please say so.
All UCSB undergraduates majoring in STEM are eligible for UCSB SACNAS Career Pathways Program funding. The following information is used for aggregate reporting and may be used for determining eligibility for certain funding sources.
Which of the following represents your status in the US?
I am a US citizen
I am a US permanent resident
I am an AB 540 student
I am an international scholar
What is your gender identity?
Woman
Man
Other gender identity
Decline to state
Are you of Hispanic/Latino origin?
Yes
No
Unknown
Decline to state
Which of the following best describes your ancestry? You may hover over each term for a definition. Select all that apply. For example, if you
are of Hispanic/Latino origin, you may be a mix of American Indian/Alaska Native as well as Caucasian ancestry. If you are
not of Hispanic/Latino origin, you may still be a mix of American Indian/Alaska Native as well as Caucasian ancestry. You may select "Unknown" if your ancestry is unknown to you.
American Indian/Alaska Native
Includes all indigenous people of North, Central, and South America
Asian
Includes all indigenous people of East Asia, Southeast Asia, and the Indian subcontinent
Black
Includes all indigenous people of Africa
Hawaiian/Pacific Islander
Includes all indigenous people of Pacific Islands, inculding Hawaii, Guam, Fiji, Philippines, Tonga, and Samoa
Caucasian
Includes all indigenous people of Europe and Middle Eastern countries, including Spain, Italy, and Portugal
Unknown
Your ancestry is unknown to you
Decline to state
Which of the following apply to you
as an undergrad? Please select all that apply.
As an undergrad, I qualify for federal disadvantaged assistance
As an undergrad, I am eligible for the Pell Grant
As an undergrad, my EFC (expected family contribution) is below $5,000
As an undergrad, my family household income is at or below the Federal poverty threshold for my household size (click
here to view Federal tables)
None of these apply to me as an undergrad
Decline to state
Are you the first generation in your family to earn a bachelor's degree?
Yes
No
Unknown
Decline to state
What is your status with the US Armed Forces?
I have previously/currently served
I have never served
Decline to state
Do you have any disabilities, defined as a physical or mental impairment that substantially limits one or more major life activities?
Yes
No
Decline to state