DO-IT Scholars Program Student Application

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This form is part of the application packet for the DO-IT Scholars program. Application packets must be complete before they can be reviewed. To learn about the other components of the application package, see Applying.

Instructions: The student applicant must complete the form below. The application materials may be submitted in your native language. If you prefer, you can print this form and submit it to DO-IT by postal mail, fax, or email. You can also access the full application in Spanish, Russian, or Vietnamese.

Deadline: January 30th. Applications for the upcoming summer are accepted throughout the school year; however, priority is given to applications received by the DO-IT Center by January 30th. Applications received after January 30th will be considered on a space available basis.

All DO-IT Scholars program offerings are contingent upon receipt of continued funding. All DO-IT Scholar participants are required to be residents of Washington State. The University of Washington reaffirms its policy of equal opportunity regardless of race, color, creed, religion, national origin, sex, sexual orientation, age, marital status, disability, or status as a disabled veteran, or Vietnam era veteran in accordance with University policy and applicable federal and state statutes and regulations.

View UW and DO-IT’s Privacy Practices for Youth Programs here: English | Spanish | Amharic | Arabic | Chinese | Somali | Vietnamese

First Name *

Last Name *

Pronouns

Pronouns that should be used to refer to you (optional):

Please specify pronouns

Address1 *

Address2

City *

State *

Zipcode *

Phone Number *

Please use the format XXX-XXX-XXXX

Email *

Date of Birth

Year

Month

Day

Gender

Ethnicity (select one)

Ethnicity Dropbox

Race (select one or more)

American Indian or Alaska Native

American Indian or Alaska Native

Asian

Asian

Black or African American

Black or African American

Native Hawaiin or Pacific Islander

Native Hawaiin or Pacific Islander

White

White

Parent/Guardian Information

Parent/Guardian First Name *

Parent/Guardian Last Name *

Parent/Guardian Phone Number *

Please use the format XXX-XXX-XXXX

Parent/Guardian Email *

School Information

High school name *

Current high school grade level *

Expected date of high school graduation *

Academic and other awards (if any)

School Contact Name (Teacher, Counselor, Administrator, or Coach) *

School Contact Email Address (Teacher, Counselor, Administrator, or Coach) *

This email address will be used to contact the teacher, counselor, administrator, or coach for additional information.

Applicant Essay Questions

Respond to each of the questions below. You may enter text in the field provided or upload a single alternative file (in audio or video format, if your disability affects your ability to respond in printed form).

1. Describe your two favorite academic areas and why they interest you. *

2. Thinking beyond high school, describe your education and career goals. *

3. Describe how you feel about meeting and corresponding with other high school students who have a variety of disabilities and are interested in going to college. *

4. Describe the nature of your disability and how it affects your learning or school participation and what accommodations you use. *

5. Describe the accommodations, support systems, and tools you use to support your disability at school and at home. *

6. Describe your computer and Internet experiences. *

7. If you use a computer, describe any software or hardware you use and what products you find most useful. *

8. State in one hundred words or less why you would like to be included in the DO‐IT Scholars program. *

9. If you received assistance from another person to complete this form, please describe fully the type of assistance you received. *

10. Additional comments (optional).

File Upload (alternative format for Questions 1-10)

Files must be less than 10 MB.
Allowed file types: jpg txt rtf html odf pdf docx ppt pptx xls xlsx xml avi mov mp3 ogg wav zip.

Leave this field blank