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Noyce Fast Track Scholarship Promissory Note - The College of ...

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Colorado State University-Pueblo’s <strong>Noyce</strong> Mathematics Scholars Program (NOY02)<br />

<strong>Fast</strong> <strong>Track</strong> <strong>Scholarship</strong> Agreement and <strong>Promissory</strong> <strong>Note</strong><br />

(Forgivable Loan) Terms and Conditions<br />

As required by the National Science Foundation, Directorate for Education and Human Resources,<br />

Division <strong>of</strong> Undergraduate Education<br />

DIRECTIONS: Students selected to receive a <strong>Noyce</strong> <strong>Fast</strong> <strong>Track</strong> <strong>Scholarship</strong> must read the General Terms, the<br />

Agreement and the <strong>Promissory</strong> <strong>Note</strong>, and provide the required information and signature. A notarized copy<br />

<strong>of</strong> this Agreement and <strong>Promissory</strong> <strong>Note</strong> is to be retained by the scholarship recipient and the original<br />

notarized form is to be sent by the recipient to Janet Nichols, <strong>Noyce</strong> Mathematics Scholars Program<br />

Coordinator, Department <strong>of</strong> Mathematics, Colorado State University, 2200 Bonforte Blvd., Pueblo, CO<br />

81001.<br />

SECTION I: Recipient Section<br />

Recipient Information<br />

Please print neatly or type<br />

1.Last Name First Name MI 2. PID Number 3. Social Security<br />

Number<br />

4. Permanent Address 5. Home Telephone 6. Date <strong>of</strong> Birth<br />

(MM/DD/YYYY)<br />

( )<br />

City State Zip Code 7. E-mail address 8. Driver’s License<br />

Number<br />

(list state abbreviation<br />

first)<br />

9. Secondary Contacts: You must provide two secondary contacts with different addresses who will know how<br />

to contact you in the future. <strong>The</strong> first reference should be a parent (if living) or other relative. This<br />

information will be used to contact recipient during the teaching or repayment periods, if necessary.<br />

A. B.<br />

Name<br />

Permanent Address<br />

City, State, Zip Code<br />

Area<br />

Code/Telephone<br />

Relationship to<br />

Borrower<br />

Last Revised March 10, 2012 Page 1 <strong>of</strong> 9


SECTION II: Terms and Conditions<br />

A. Purpose <strong>of</strong> the <strong>Noyce</strong> Scholars Program – the Recipient’s Service Obligation<br />

In recognition <strong>of</strong> the critical correlation between teacher quality, including mastery <strong>of</strong> content knowledge, and<br />

student achievement, the National Science Foundation’s Robert <strong>Noyce</strong> <strong>Scholarship</strong> Program, named for a<br />

pioneer <strong>of</strong> semiconductor development and founder <strong>of</strong> the semiconductor industry, seeks to encourage<br />

talented mathematics, science, and engineering students and current science, technology, engineering, or<br />

mathematics (STEM) pr<strong>of</strong>essionals to pursue teaching careers. Grants to institutions <strong>of</strong> higher education<br />

provide funds for scholarships and stipends for STEM students and pr<strong>of</strong>essionals who commit to teaching in<br />

high-need school districts. <strong>The</strong> National Science Foundation awarded funds (DUE 1136426) to CSU-Pueblo’s<br />

<strong>Noyce</strong> Scholars Program to provide such awards to individuals seeking secondary teaching licensure in<br />

mathematics at Colorado State University-Pueblo.<br />

Consistent with the requirements for funding provided by the National Science Foundation (NSF), a recipient<br />

accepts a <strong>Noyce</strong> Scholars <strong>Fast</strong> <strong>Track</strong> <strong>Scholarship</strong> with the understanding that it carries with it a service<br />

obligation. More specifically, in exchange for a one-year fast track scholarship, the recipient agrees to teach in<br />

a “high-need local educational agency” (see definition in Section IID below) for two years upon completion <strong>of</strong><br />

the secondary mathematics licensure program at CSU-Pueblo. <strong>The</strong> recipient understands that the period <strong>of</strong><br />

time for which he or she receives scholarship support will be determined in comparison to full-time enrollment<br />

(12 credits or more during an academic semester and 6 credits or more during a summer seemster) in the<br />

teacher preparation program. Similarly, the recipient understands that the period <strong>of</strong> time he or she must<br />

teach in a high-need public school will be determined in comparison to what the school district considers to be<br />

teaching on a full-time basis. Full-time basis does not include summer sessions or, for those school districts<br />

that operate year-round programs, optional intersession periods. <strong>The</strong> total service obligation must be<br />

completed within eight (8) years after completion <strong>of</strong> the licensure program at CSU-Pueblo.<br />

CSU-Pueblo is committed to meeting the needs <strong>of</strong> high need educational agencies throughout southeastern<br />

Colorado, and prefers that all individuals who receive support from its <strong>Noyce</strong> Scholars Program complete their<br />

licensure program requirements at CSU-Pueblo and fulfill their service obligation in the region. However, the<br />

program recognizes that there are times when an individual’s needs are not able to be met at this institution<br />

for unforeseen reasons and for those that are beyond the control <strong>of</strong> CSU-Pueblo. Accordingly, the <strong>Noyce</strong><br />

Scholars Program at CSU-Pueblo has chosen to not penalize students who receive support from the program<br />

and thereafter transfer to another accredited institution to complete a licensure program in secondary<br />

mathematics that has been reviewed and approved by CSU-Pueblo’s <strong>Noyce</strong> Scholars Program. Any such<br />

individual is required to complete the terms and conditions stated in Section IIC below, and failure to do so will<br />

result in the obligation stated in Section IIE (Repayment) and Section IV (<strong>Promissory</strong> <strong>Note</strong>).<br />

B. <strong>Scholarship</strong> Award - Maximum and Minimum<br />

<strong>The</strong> maximum amount <strong>of</strong> a fast track scholarship award to any individual is $18,000. <strong>The</strong> specific amount <strong>of</strong><br />

each scholarship is based on the actual cost <strong>of</strong> attendance for that individual, as determined by CSU-Pueblo’s<br />

Office <strong>of</strong> Financial Aid, for a maximum <strong>of</strong> two academic (spring or fall) semesters and two summer semesters<br />

<strong>of</strong> continuous enrollment. Each semester <strong>of</strong> support after the first semester is dependent on the student<br />

maintaining good academic progress as defined in the award letter provided to each particular student. Each<br />

student will be informed <strong>of</strong> his or her maximum award possible when he or she is initially <strong>of</strong>fered the<br />

scholarship by CSU-Pueblo’s <strong>Noyce</strong> Scholars Program.<br />

Last Revised March 10, 2012 Page 2 <strong>of</strong> 9


C. Recipient’s Retention <strong>of</strong> <strong>Scholarship</strong> for Meeting the Service Obligation<br />

<strong>The</strong> recipient will not be required to repay to CSU-Pueblo the scholarship provided with funds under the NSF<br />

Grant Award (DUE 1136426) if CSU-Pueblo’s <strong>Noyce</strong> Scholars Program determines that (1) the recipient meets<br />

the academic requirements <strong>of</strong> the program for which the <strong>Noyce</strong> funds were awarded and (2) the recipient has<br />

fulfilled his or her service obligation.<br />

To determine that the recipient has met the service obligation, CSU-Pueblo’s <strong>Noyce</strong> Scholars Program must<br />

receive information to confirm that the recipient, within eight (8) years <strong>of</strong> completing a secondary<br />

mathematics licensure program approved by CSU-Pueblo’s <strong>Noyce</strong> Scholars program, has taught in a high-need<br />

local education agency for the required number <strong>of</strong> years. <strong>Scholarship</strong> recipients who receive <strong>Noyce</strong> support<br />

from CSU-Pueblo for exactly one (summer or academic) semester or for one summer semester and one<br />

academic semester are required to teach at least one year in a high need school district. <strong>Scholarship</strong> recipients<br />

who receive <strong>Noyce</strong> support for a full academic year (two academic semesters) are required to teach at least<br />

two years in a high need school district, regardless <strong>of</strong> the number <strong>of</strong> summer semesters for which he or she<br />

receives <strong>Noyce</strong> support.<br />

So that CSU-Pueblo’s <strong>Noyce</strong> Scholars Program may obtain the information it needs to make these<br />

determinations, the recipient agrees to have the school district in which he or she has taught provide CSU-<br />

Pueblo’s <strong>Noyce</strong> Scholars Program such information as the program may require in order to confirm that:<br />

1. <strong>The</strong> school in which the recipient has taught is “high-need” as defined in the “Definition <strong>of</strong> High-Need<br />

Local Education Agency” below, and<br />

2. <strong>The</strong> recipient taught on a full-time basis.<br />

Upon completion <strong>of</strong> an approved secondary mathematics licensure program, CSU-Pueblo’s <strong>Noyce</strong> Scholars Program<br />

will provide the recipient written guidance that explains the information that the recipient must have the school(s)<br />

provide to CSU-Pueblo’s <strong>Noyce</strong> Scholars Program and the date or dates that this information is due.<br />

[NOTE: To prevent an award recipient becoming liable for repaying the scholarship because <strong>of</strong> a school<br />

district’s delay in forwarding the required employment information to CSU-Pueblo’s <strong>Noyce</strong> Scholars Program,<br />

the program will also accept employment information directly from the recipient. In this case, within eight (8)<br />

years <strong>of</strong> completion <strong>of</strong> a secondary mathematics licensure program approved by CSU-Pueblo’s <strong>Noyce</strong> Scholars<br />

program, the recipient must submit to the program (1) a notarized statement that he or she has asked the<br />

district(s) to provide the needed information and the date(s) this request was made, and (2) a copy <strong>of</strong> the<br />

personal and employment information each school has been asked to submit. When a recipient chooses this<br />

option, CSU-Pueblo’s <strong>Noyce</strong> Scholars Program‘s determination that he or she is meeting the service obligation<br />

is only provisional. Until each school provides the information, the recipient retains a continuing responsibility<br />

to work to get each school to submit the information as soon as possible.]<br />

D. Definition <strong>of</strong> High-Need Local Educational Agency<br />

Service must be completed within 8 years after completion <strong>of</strong> the program for which the scholarship was<br />

awarded and must be performed in a high-need local educational agency as defined in the FY 2011 National<br />

Science Foundation solicitation for <strong>Noyce</strong> <strong>Scholarship</strong> Grants. Service must be started within twenty four (24)<br />

months after completion <strong>of</strong> the program for which the scholarship was awarded or the scholarship converts to<br />

a loan that must be repaid, unless the recipient qualifies for discharge (Section II G) or deferment (Section IV<br />

E). For the purposes <strong>of</strong> this agreement, a “high-need local education agency” is a local educational agency that<br />

serves an elementary or a secondary school located in an area in which one or more <strong>of</strong> the following<br />

conditions is met at the time <strong>of</strong> the recipient’s initial employment:<br />

1) a high percentage <strong>of</strong> individuals from families with incomes below the poverty line;<br />

2) a high percentage <strong>of</strong> secondary school teachers not teaching in the content area in which the<br />

teachers were trained to teach; or<br />

3) a high teacher turnover rate.<br />

Last Revised March 10, 2012 Page 3 <strong>of</strong> 9


E. Repayment for Failure to Meet Academic Requirements or Service Obligation<br />

<strong>The</strong> <strong>Noyce</strong> award will be considered a loan that must be repaid with interest* according to the terms <strong>of</strong> this<br />

<strong>Note</strong> (a) if the recipient fails to satisfy the academic requirements <strong>of</strong> the academic program for which the<br />

<strong>Noyce</strong> funds were awarded; or (b) if the recipient fails to complete the service requirement, or (c) if the<br />

recipient does not receive a waiver or suspension <strong>of</strong> the service obligation (Section II G), or (d) if the recipient<br />

fails to provide adequate documentation for a deferment (as described in Section IV E), or (e) in the event that<br />

the recipient transfers to a secondary mathematics licensure program that has been approved by CSU-Pueblo’s<br />

<strong>Noyce</strong> Scholars program at another accredited institution and fails to complete his/her licensure program<br />

within 24 months.<br />

If the recipient does not fulfill his or her service obligation within eight (8) years by teaching the required<br />

number <strong>of</strong> years in a high-need local educational agency (see Section IIC), the recipient becomes obligated to<br />

fully repay the scholarship. If the recipient withdraws from CSU-Pueblo prior to completion <strong>of</strong> its secondary<br />

mathematics licensure program, or transfers to another accredited institution and withdraws from that<br />

institution prior to completion <strong>of</strong> the secondary mathematics licensure program that has been approved by<br />

CSU-Pueblo’s <strong>Noyce</strong> Scholars program, or fails to meet the other academic requirements <strong>of</strong> the scholarship,<br />

the recipient becomes obligated to start repayment <strong>of</strong> the scholarship within six (6) months after his or her<br />

withdrawal from CSU-Pueblo or the other accredited institution.<br />

<strong>The</strong> recipient has twenty-four (24) months following completion <strong>of</strong> the CSU-Pueblo Teacher Education<br />

Program in mathematics to begin teaching in a high-need school or else repayment <strong>of</strong> the scholarship will<br />

start, unless the recipient receives a waiver or suspension <strong>of</strong> service obligation (Section IIG) or the recipient<br />

qualifies for a deferment (Section IV E).<br />

If upon completion <strong>of</strong> the secondary mathematics licensure program from CSU-Pueblo and obtaining a<br />

teaching license, the recipient teaches in a high-need local educational agency for a period that is less than the<br />

period <strong>of</strong> his or her service obligation, the recipient becomes responsible for repayment <strong>of</strong> the percentage <strong>of</strong><br />

the period for which the service obligation was not fulfilled.<br />

Example: An individual receives a scholarship in the total amount <strong>of</strong> $18,000 for one summer and two<br />

academic semesters <strong>of</strong> support while completing the secondary mathematics licensure program at CSU –<br />

Pueblo. <strong>The</strong> individual works in a high-need local educational agency for one full school year. <strong>The</strong><br />

individual then moves and takes a teaching position in a school district that is not high-need. If the<br />

individual remains in the district that is not high-need, then eight (8) years after completion <strong>of</strong> the<br />

secondary mathematics licensure program, the individual has fulfilled one-half (1/2) <strong>of</strong> his or her service<br />

obligation and so must repay one-half (1/2) <strong>of</strong> the scholarship, or $9,000.<br />

Until the recipient either satisfies the service obligation or repays the scholarship, the recipient agrees to<br />

provide CSU-Pueblo a current home address and telephone address, an e-mail address, and a current work<br />

address and telephone number, as well as other needed identifying information, as requested by CSU-Pueblo.<br />

In addition, the recipient understands that CSU-Pueblo and the high-need school district are or will be using<br />

the recipient’s Social Security number so that CSU-Pueblo (or CSU-Pueblo’s contracted agent) can, if necessary,<br />

secure payment <strong>of</strong> these amounts from the recipient if he or she fails to meet the service obligation or<br />

academic requirements.<br />

*Interest on the amount <strong>of</strong> the scholarship is applied as specified in the provisions <strong>of</strong> part B or D <strong>of</strong> Title IV <strong>of</strong><br />

the Higher Education Act <strong>of</strong> 1965. See Section IVC.<br />

Last Revised March 10, 2012 Page 4 <strong>of</strong> 9


F. Default<br />

If within twenty-four (24) months <strong>of</strong> ceasing to be enrolled at CSU – Pueblo or an approved secondary<br />

mathematics licensure program at another accredited institution or within eight (8) years <strong>of</strong> completion <strong>of</strong> a<br />

secondary mathematics licensure program approved by CSU-Pueblo’s <strong>Noyce</strong> Scholars Program, the recipient<br />

fails to provide CSU-Pueblo’s <strong>Noyce</strong> Scholars Program with contact information stated above (Section II E) or<br />

evidence to discharge the required payment (Section II G) as requested by CSU-Pueblo’s <strong>Noyce</strong> Scholars<br />

Program, the loan will be determined in default. In the event <strong>of</strong> failure to make monthly loan payments for a<br />

period that last 90 days or more, the loan will be determined in default. If the loan is in default, the entire<br />

unpaid indebtedness may become immediately due and payable. CSU-Pueblo may disclose that the borrower<br />

has defaulted, along with other relevant information, to credit bureau organizations, collection agencies and<br />

the federal government. In the event <strong>of</strong> default and if the loan is referred to a private collection agency, the<br />

recipient is responsible to pay collection agency fees in addition to the principal balance until the entire loan is<br />

paid in full. Under default, the recipient will lose all rights to cancellation or loan forgiveness.<br />

All repaid scholarship funds, including the applicable interest (see Section IV C) and late fees (see Section IV<br />

A2), less grantee administrative costs associated with collection <strong>of</strong> the repayment not to exceed 5% <strong>of</strong> the<br />

forfeited amount, will be returned to the United States Treasury.<br />

G. Discharge <strong>of</strong> a Required Repayment<br />

CSU-Pueblo will waive or suspend an obligation to repay the scholarship <strong>of</strong> a recipient who has died, or who is<br />

not employable as a teacher due to a documented and physician verified permanent physical or mental<br />

disability or some other extraordinary circumstance that arises through no fault <strong>of</strong> the recipient and which<br />

CSU – Pueblo’s <strong>Noyce</strong> Scholars Program, in consultation with NSF, considers compelling. (See Section IV F <strong>of</strong><br />

<strong>Promissory</strong> <strong>Note</strong>.)<br />

Upon receipt <strong>of</strong> acceptable documentation and approval <strong>of</strong> the discharge request, CSU-Pueblo will return to<br />

the recipient, or for a discharge <strong>of</strong> death, the recipient’s estate, those payments received after the date <strong>of</strong><br />

eligibility requirements for the discharge were met and prior to the date <strong>of</strong> the discharge was approved. CSU-<br />

Pueblo also returns any payments received after the date the discharge was approved.<br />

H. Exit Conference<br />

Before the recipient withdraws from CSU-Pueblo, CSU-Pueblo’s <strong>Noyce</strong> Scholars Program will provide the<br />

recipient an opportunity to review fully the terms and conditions <strong>of</strong> this scholarship.<br />

Last Revised March 10, 2012 Page 5 <strong>of</strong> 9


SECTION III: <strong>Scholarship</strong> Agreement<br />

A) I verify that I am enrolled full time in a program <strong>of</strong> study at CSU-Pueblo leading to a license as a<br />

secondary education mathematics teacher, AND I understand that this support will end if I cease to be<br />

enrolled at CSU-Pueblo.<br />

B) I verify that I am U.S. Citizen or permanent resident alien.<br />

C) I understand that one <strong>of</strong> the requirements <strong>of</strong> continued <strong>Noyce</strong> support is maintaining satisfactory<br />

academic progress as this is defined in my CSU-Pueblo <strong>Noyce</strong> Scholars award letter.<br />

D) I understand that my CSU-Pueblo <strong>Noyce</strong> Scholars scholarship might affect other financial aid awards,<br />

and it is up to me to verify this by checking with the CSU-Pueblo Financial Aid Office.<br />

E) I agree to achieve teacher licensure in secondary mathematics education AND gain direct teaching<br />

experience in a local educational agency that serves an elementary or a secondary school located in<br />

an area in which one or more <strong>of</strong> the following conditions is met at the time <strong>of</strong> my initial employment:<br />

1) a high percentage <strong>of</strong> individuals from families with incomes below the poverty line;<br />

2) a high percentage <strong>of</strong> secondary school teachers not teaching in the content area in which the<br />

teachers were trained to teach; or<br />

3) a high teacher turnover rate.<br />

F) I agree to work full-time in an eligible school district for a minimum <strong>of</strong> two years if I receive <strong>Noyce</strong><br />

support during two academic semesters (regardless <strong>of</strong> the number <strong>of</strong> summer semesters <strong>of</strong> <strong>Noyce</strong><br />

support received), or to work full-time in an eligible school district for a minimum <strong>of</strong> one year if I<br />

receive <strong>Noyce</strong> support for either exactly one (summer or academic) semester or for one summer<br />

semester and one academic semester. I understand this service obligation must be completed within<br />

eight (8) years <strong>of</strong> completion <strong>of</strong> the secondary mathematics licensure program at CSU-Pueblo.<br />

If I am unable to find full-time employment, but do find part time employment (½ time or greater) in<br />

an eligible school district, I agree to work proportionally longer to meet my service obligation. For<br />

example, if I have a service obligation <strong>of</strong> 2 years and I work ½ time at an eligible school district, I will<br />

have a service obligation <strong>of</strong> 4 years at ½ time employment.<br />

G) I agree to provide CSU-Pueblo’s <strong>Noyce</strong> Scholars Program with written evidence <strong>of</strong> compliance with the<br />

above requirements, AND to notify CSU-Pueblo at such times as I am not in compliance with any <strong>of</strong> the<br />

requirements.<br />

H) I agree to inform CSU-Pueblo’s <strong>Noyce</strong> Scholars Program promptly in writing or electronically <strong>of</strong> any<br />

change in my name, permanent address or other personal information disclosed in the Recipient<br />

Section (Section I) <strong>of</strong> this agreement, AND if my employment in a high-need school district ceases prior<br />

to fulfilling the required service obligation <strong>of</strong> the scholarship.<br />

I) I give permission to CSU-Pueblo’s <strong>Noyce</strong> Scholars Program to release this information to the National<br />

Science Foundation, if required, AND I give CSU – Pueblo permission to publicize my <strong>Noyce</strong> Scholars<br />

Award and post my photograph.<br />

Last Revised March 10, 2012 Page 6 <strong>of</strong> 9


SECTION IV: <strong>Promissory</strong> <strong>Note</strong><br />

I understand that the <strong>Noyce</strong><strong>Fast</strong> <strong>Track</strong> <strong>Scholarship</strong> is a forgivable loan if I meet the service obligation and<br />

academic requirements outlined in Section II and III.<br />

I agree that if I fail to meet the conditions described in Section II “Terms and Conditions” or Section III<br />

“<strong>Scholarship</strong> Agreement”, or if I have ceased to pursue a course <strong>of</strong> study in secondary mathematics education<br />

approved by CSU – Pueblo’s <strong>Noyce</strong> Scholars Program, I will repay either the full amount <strong>of</strong> the scholarship<br />

received or a prorated amount according to the fraction <strong>of</strong> teaching employment obligation not completed.<br />

A. Repayment<br />

1. I agree to begin repaying my <strong>Noyce</strong> scholarship beginning thirty-one (31) days after failing to meet any<br />

<strong>of</strong> the requirements for which the <strong>Noyce</strong> funds were awarded. <strong>The</strong>se requirements include:<br />

a. Maintaining enrollment with good academic standing as defined in the <strong>Noyce</strong> Scholars Award<br />

Letter (attached hereto);<br />

b. Completion <strong>of</strong> a secondary mathematics licensure program approved by CSU – Pueblo’s <strong>Noyce</strong><br />

Scholars Program at CSU-Pueblo or another accredited institution as discussed in Section II (a);<br />

c. Applying for and receiving a secondary teachers license in mathematics;<br />

d. Successful participation in all semi-annual and annual submission <strong>of</strong><br />

demographic/employment/education related survey information associated with CSU-Pueblo’s<br />

<strong>Noyce</strong> Scholars Program;<br />

e. Meeting the service obligation <strong>of</strong> completing 2 years <strong>of</strong> teaching in an eligible high-need school<br />

district for one full year <strong>of</strong> <strong>Noyce</strong> Scholars support within eight (8) years <strong>of</strong> completing the<br />

secondary mathematics licensure program at CSU-Pueblo.<br />

I will be expected to begin repaying my <strong>Noyce</strong> scholarship beginning thirty-one (31) days after<br />

declaring that I do not intend to fulfill the service requirement; or beginning six (6) months after CSU-<br />

Pueblo has determined that I have ceased to be enrolled in a mathematics secondary teacher<br />

education program.<br />

2. I agree to make monthly payments to the billing agent <strong>of</strong> CSU-Pueblo which cover the outstanding<br />

principal and interest (See Section II E), according to a schedule established by the billing agent, which<br />

calls for complete repayment within five (5) years after I enter repayment status (except as provided in<br />

Section IV B and C below).<br />

If I fail to make any monthly payment as required by the schedule established by the billing agent, my<br />

loan will be subject to late fee <strong>of</strong> $2.00 per month. If my failure to make scheduled monthly payments<br />

persists for a period <strong>of</strong> 90 days, the billing agent, without further notice, may accelerate the balance <strong>of</strong><br />

the outstanding principal due, and I promise to pay such amount.<br />

It is further my understanding that if I do not make the monthly payments as required by the schedule<br />

by the billing agent, that collection efforts may commence, including notification <strong>of</strong> credit bureaus<br />

concerning my default and litigation, similar to the collection efforts which are used by lenders and<br />

guarantee agencies in the guaranteed student loan program.<br />

B. Loan Cancellation (Service Credit)<br />

To cancel a one year <strong>Noyce</strong> Scholars <strong>Fast</strong> <strong>Track</strong> <strong>Scholarship</strong> award, I understand that under this <strong>Note</strong> I am<br />

required to complete two years <strong>of</strong> service as a mathematics teacher in a high-need school district that<br />

meets one or more <strong>of</strong> the criteria identified in Section II and Section III.<br />

If I do not satisfy the academic requirements <strong>of</strong> the program for which CSU-Pueblo’s <strong>Noyce</strong> Scholars<br />

Program funds were awarded, I will not be eligible for the loan cancellation benefit.<br />

Last Revised March 10, 2012 Page 7 <strong>of</strong> 9


C. Interest<br />

Interest on this loan shall accrue from the beginning <strong>of</strong> the repayment period. My fixed interest rate is 5%.<br />

D. Billing Service<br />

Should I enter into repayment <strong>of</strong> the <strong>Noyce</strong> funds, the billing agent for the CSU – Pueblo will be ECSI. CSU-<br />

Pueblo reserves the right to change the billing agent as needed. In the event that the billing agent is<br />

changed, I will be notified <strong>of</strong> the new billing agent by CSU-Pueblo’s <strong>Noyce</strong> Scholars Program.<br />

E. Deferment<br />

I understand that I will not be considered in violation <strong>of</strong> the repayment schedule during the time that I am:<br />

1. Enrolled as a full time student at CSU – Pueblo AND enrolled in the secondary teacher education<br />

program in mathematics; or<br />

2. Teaching in a qualified high-need school district while meeting service obligation; or<br />

3. Serving, not in excess <strong>of</strong> three (3) years, on active duty as a member <strong>of</strong> the armed services <strong>of</strong> the<br />

United States; or<br />

4. Temporarily disabled, for a period not to exceed three (3) years, as established by sworn affidavit <strong>of</strong> a<br />

qualified physician; or<br />

5. Unable to secure employment for a period not to exceed twelve (12) months by reason <strong>of</strong> the care<br />

required by a spouse who is disabled; or<br />

6. Seeking and unable to find employment as a science or mathematics teacher in a high-need school<br />

district for a single period not to exceed twenty four (24) months; or<br />

7. Enrolling in a secondary mathematics licensure program approved by CSU-Pueblo’s <strong>Noyce</strong> Scholars<br />

Program to start no later than the third academic semester after a transfer to another accredited<br />

institution.<br />

During the time I qualify for any <strong>of</strong> the exceptions described Section IV E, I need not make the scholarship<br />

repayments described in described in Section IV A. In order to qualify for any <strong>of</strong> these exceptions, I must<br />

promptly notify CSU-Pueblo’s <strong>Noyce</strong> Mathematics Scholars Program <strong>of</strong> my claim and provide supporting<br />

documentation acceptable to CSU – Pueblo’s <strong>Noyce</strong> Scholars Program.<br />

<strong>The</strong> billing agent shall extend the five-year scholarship repayment period described in Section IV A by a<br />

period equal to the length <strong>of</strong> time I meet any <strong>of</strong> the conditions in Section IV E.<br />

F. Discharge <strong>of</strong> a Required Repayment<br />

I understand that the <strong>Noyce</strong> Scholars Program shall waive my repayment obligation if it determines that:<br />

1. On the basis <strong>of</strong> the sworn affidavit <strong>of</strong> a qualified physician, I am unable to work as a secondary teacher<br />

because <strong>of</strong> an impairment or disability that is expected to continue indefinitely or result in death;<br />

2. On the basis <strong>of</strong> a death certificate or other evidence conclusive under Colorado law, my death has<br />

occurred; or<br />

3. Documented circumstances have occurred which CSU – Pueblo’s <strong>Noyce</strong> Scholars Program, in<br />

consultation with NSF, considers as a compelling reason to excuse repayment.<br />

G. General<br />

Last Revised March 10, 2012 Page 8 <strong>of</strong> 9


1. I agree to advise CSU – Pueblo’s <strong>Noyce</strong> Scholars Program in writing <strong>of</strong> any change in name, address, or<br />

deferment status as described in Section IV E.<br />

2. I understand that I may appeal any determination made by CSU – Pueblo’s <strong>Noyce</strong> Scholars Program<br />

that I am not in compliance with any <strong>of</strong> the requirements <strong>of</strong> the program, and that appeals must be<br />

made in writing to CSU – Pueblo’s <strong>Noyce</strong> Scholars Program within 60 days <strong>of</strong> receipt <strong>of</strong> communication<br />

that I am in non-compliance.<br />

3. I understand that I must be enrolled full time in a secondary mathematics teacher education program<br />

at the CSU – Pueblo and if I transfer to another college, I am no longer eligible for the scholarship and<br />

will need to start repayment <strong>of</strong> any scholarship funds received to that point unless I meet cancellation<br />

or deferment requirements stated in Section IV B, E, or F.<br />

4. I understand that I must maintain satisfactory academic progress as determined by CSU – Pueblo’s<br />

<strong>Noyce</strong> Scholars Program, and that scholarship support will end if I do not make satisfactory progress<br />

during any term <strong>of</strong> my enrollment.<br />

5. I understand that if I am more than 90 days past due with payments towards my loan that CSU-Pueblo<br />

will withhold all services (such as transcript requests or course registration) until my delinquent<br />

(late)/defaulted loan account has been brought current and/or paid in full.<br />

6. I understand that if I fail to pay my loan as agreed, my loan will be assigned to a collection agency, and<br />

may be accelerated (loan balance due and payable IN ITS ENTIRETY); and I will be required to pay all<br />

collection, court, and attorney’s fees if my loan becomes, or continues to be, past due.<br />

I attest that I have read and understand my repayment responsibilities and the options available to me. I<br />

understand that this is a loan that must be repaid, with accrued interest, if I fail to meet the service<br />

obligation or any other <strong>of</strong> the requirements listed in the sections above. My signature below certifies that I<br />

have read and agree to my commitments presented in the terms and conditions (Section II), the scholarship<br />

agreement (Section III), and the promissory note (Section IV).<br />

Print Full Name Signature Date<br />

STATE OF COLORADO )<br />

) ss<br />

COUNTY OF PUEBLO )<br />

Subscribed and affirmed or sworn before me by<br />

this day <strong>of</strong> , 20 .<br />

(student)<br />

________________________ _ ____________________________<br />

NOTARY PUBLIC<br />

My Commission expires<br />

Last Revised March 10, 2012 Page 9 <strong>of</strong> 9

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