Donald F. & Mildred Topp Othmer Scholarship Awards Form

Nominator's Name*

First Name

Last Name

Nominator's Email*

Nominee's Name*

First Name

Last Name

Nominee's Email Address*

Nominee's Mailing Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Nominee's AIChE Membership No.*

University/College Attending:*

Expected Graduation Date:*

Cumlulative GPA*

Maximum Possible GPA*

Cumulative Credit Hours*

Credit Hours for all semesters competed

Cumulative Chemical Engineering GPA*

Maximum Possible Chemical Engineering GPA *

Cumulative Credit Hours in Chemical Engineering*

ChE Department Courses only

Upload Letter of Nomination*

No File Chosen

File uploads may not work on some mobile devices.

Upload a word document or a .pdf of a letter of nomination from the AIChE Student Chapter Advisor containing, but not limited to, the following: a) Verification of the nominee's GPAs and projected completion date. b)An evaluation of the nominee's academic performanceand participation in AIChE Student Chapter and other professional activities. (Note: Your advisor may also send the letter separately, if they prefer. Simply attach a document stating as such in place of the letter). It must be sent to awards@aiche.org with the subject line: Othmer Topp Scholarship

Upload Statement From the Nominee*

No File Chosen

File uploads may not work on some mobile devices.

Upload a word document or a .pdf of a statment from the nominee, not to exceed 300 words, outlining his/her career plans and objectives in Chemical Engineering and including, but not limited the following: a)Immediate plans after after graduation and area(s) of Chemical Engineering of most interest b)Long-range career objectives

Unofficial Transcript from the Nominee*

No File Chosen

File uploads may not work on some mobile devices.

Upload your current school transcript as a PDF. This must indicate that you have completed at least half of your undergraduate curriculum.