Educationusa academy 2019 Scholarship Application Form Full name


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2019-EdUSA-Academy-Scholarship-Application-Form
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EducationUSA Academy Scholarship Application Form



EducationUSA Academy 2019 Scholarship Application Form
Full name: _____________

Last Name First Name MI


Date of Birth (DD/MM/YY): ________________________________________________________________
City and country of birth: ____________________________________________________________________
E-mail: _____________________________________
Telephone number: _______________________________________________________________________________
School name: _____________________________________________________________________________________
Year of study: _____________________________________________________________________________________
If available, TOEFL/IELTS score from within past 6 months: ________________________________________________
If available, estimate of English proficiency on CEFR scale: _________________________________________________
2019 Host Institutions and Program Dates:


Host Institution

Start Date

End Date

Embry-Riddle Aeronautical University

June 9

June 29

Syracuse University

June 29

August 9

St. John’s University

June 30

July 13

University of Colorado Boulder

July 1

July 27

University of Madison Wisconsin

July 1

July 19

University of Massachusetts Amherst

July 6

August 13

University of Tennessee Knoxville

July 6

August 3

Temple University

July 7

July 27

Northwestern University

July 7

July 27

St. Cloud State University

July 7

July 27

University of North Georgia

July 8

July 26

Johns Hopkins University

July 8

August 2

Diablo Valley College

July 13

August 10

Boston University

July 14

August 3

University of Alabama in Huntsville

July 14

July 28

The earliest EducationUSA Academy starts June 9 and the latest Academy ends August 13.

Are you available to attend an Academy at any time between these dates? ☐ Yes ☐ No
If no, what are the nominee’s dates of availability? _________
Placement: Do you have a preference for where you would like to be placed? ☐ Yes ☐ No
If yes, please list up to three institutions in order of preference*: ______________________________________

___________________________________________________________________________________________

*Please note that we will attempt to accommodate placement requests. However, we cannot guarantee placement at particular host institutions.
Please provide a statement of interest (500 words or less) answering the question “Why do you want to participate in EducationUSA Academy and what do you hope to gain from the experience?” You may type the essay in the space below or attach it in a separate document.

Please email completed application form to Tashkent-Advising@state.gov by February 28, 2019.




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