Robert Noyce Scholarship Program
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Robert Noyce
Scholarship Program
3307 3rd Avenue West
Suite 307
Seattle, WA 98119
noycescholarship@spu.edu
206-281-2399 Phone
206-378-5400 Fax

Robert Noyce Scholarship Form

SECTION I: NOYCE SCHOLAR INFORMATION

Name:
SPU ID:
Address:
Phone:
Email:
Has any of your contact information changed in the past six months?

Graduation / Separation date:
Date certification was obtained:
Subjects in which you are certified:
How many years did you receive a Noyce scholarship?

Are you a Noyce Scholar or a PhysTEC Noyce Scholar?


SECTION II: Employment Status and Verification


A: EMPLOYMENT STATUS

I am not currently teaching in a position eligible for forgiveness but plan to complete the requirements for cancellation within six years following graduation and request Deferment in Anticipation of Cancellation. (During periods of deferment interest will
not accrue.)
I am teaching in a position eligible for forgiveness and request Deferment in Anticipation of Cancellation. (During periods of deferment interest will not accrue.)
I have completed a year of teaching in a position eligible for cancellation.
I will not be teaching in a position eligible for forgiveness and wish to begin repayment of the remaining balance of my conditional scholarship.
I am teaching in a high-needs district, but was not able to secure a full-time position for this year. (Note: You must submit a detailed statement of your effort put toward obtaining full-time employment, in addition to employment verification.)


B: EMPLOYMENT CERTIFICATION

School Name:
School District:
School Address:
City, State, Zip
Job Title:
Subjects Taught:
Are you teaching within your area of certification?


How many full years have you already completed in a high-need district?


Date you expect to complete your Noyce teaching requirement?



C: DECLARATION

“I declare that the information shown above is true and accurate. I further declare that I will notify Seattle Pacific University immediately upon any change in my status or contact information.”

Name:
Date:


D: SUPPLEMENTS

In addition to this form, you are required to submit copies of official documentation (teaching contract OR letter from supervisor) verifying your teaching status. Please select which documents we should expect to receive from you via mail or fax within the next two weeks.

Teaching contract
Letter from supervisor
Statement of teaching explanation (Not needed for full-time positions.)