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ALFRED P. SLOAN FOUNDATION
SLOAN INDIGENOUS GRADUATE PARTNERSHIP
IN MATHEMATICS, SCIENCE AND ENGINEERING
SLOAN SCHOLAR ACADEMIC REPORT FORM
Date of Request ______________________________________________________________________________
Name (First, Middle, Last Name) Social Security Number
Street Address, City, State/Zip Code Check if address has changed
Telephone Email
University Department
______________________________________________________________________________________________________
Faculty Member Program Start Date
Semester/Quarter of Report ______________________________________________________________
ACADEMIC PROGRESS REPORT
GPA for Semester/Quarter _________ □ Master’s □ Ph.D.
Expected Date of Completion _______________________________________
Major Examinations During Semester/Quarter (if applicable):
Examination Result
Examination Result
Other recent accomplishments/events during academic program:
ACADEMIC ADVISOR AND PROGRAM DIRECTOR AGREEMENT
We are, respectively, the academic advisor and faculty member designated to approve NACME forms for the student
named above. We have reviewed the information detailed above and hereby certify that it accurately reflects both the
current enrollment and academic progress of this Sloan Scholar.
Academic Advisor (Print) Academic Advisor (Signature and Date)
Program Director (Print) Program Director (Signature and Date)
Once signed by your Academic Advisor and Program Director, please return this form to
your principal AIGP contact for forwarding to NACME.