Educationusa academy 2019 Scholarship Application Form Full name

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 [e-mail] by February 28, 2019.