Date Rec’d (leave blank, for tusa records only) appication form for 2012 taiwan –U. S. Sister relations alliance ambassador scholarship program

Date Rec’d______________ (leave blank, for TUSA records only)

APPICATION FORM FOR 2012 TAIWAN –U.S. SISTER RELATIONS ALLIANCE AMBASSADOR SCHOLARSHIP PROGRAM

INSTRUCTIONS:

This application form MUST be typed and completed by the applicant. Each question must be answered clearly and completely. Detailed answers are required in order for the TUSA Education Committee to consider your application and also to make the most appropriate arrangements. If necessary, additional pages may be attached.

1. PERSONAL DATA

a. FULL NAME:	Title: Mr./Mrs./Ms. Last Name: First Name(s) & Middle Initial:				Send a copy of your Student I.D.to: [e-mail]
^b. PLACE OF BIRTH
^c. NATIONALITY
^d. CONTACT INFORMATION I)Select someone who can get information to you at anytime, anywhere.		Permanent Address (Parents Home): Your Current Mailing Address: Telephone: Cell: E-mail:
^e. GENDER		□ Male 　 □ Female
^f. MARITAL STATUS		□ Single □ Married
^g^.DATE OF BIRTH		Day: Month: Year:
^h^. HEALTH CONDITION		□ Excellent □ Good □ Fair
^i^. Do You Have Any Chronic Diseases		□ None □ Yes, If yes, Please specify:
J. Early Decision		^I will apply for early decision of admission on Feb. 15: Yes_______No______.

2. LANGUAGE PROFICIENCY:

Mandarin language proficiency is not required. An appropriate class will be assigned according to your proficiency if accepted.

<sup>a) Have you studied the Mandarin Language? Yes_____No_____. If yes, please state how long and where you studied ________________. List sites in Taiwan or China where you have received earlier Mandarin education/training.

Class level (circle one): Beginner Novice Intermediate Advanced</sup>
3. PRESENT STATUS

^a. Name and Location of Department /College/Univ now Attending		b.Please enter cumulative GPA	c. Dates of Attendance:
d. Major, You may also add Special tarent
e. School Year Classification (Fr, So, Jr, Sr,)

4. PLEASE SUBMIT TWO 300 WORD ESSAYS ON SEPARATE SHEETS ON: 1) WHAT IS THE MOST IMPORTANT THING YOU FEEL THE TUSA EDUCATION COMMITTEE SHOULD KNOW ABOUT YOU? 2) WHAT ARE YOUR CAREER PLANS AND HOW DID YOU ARRIVE AT THEM? (Please attach your two essays to the Application Form)



5. EDUCATIONAL BACKGROUND.

Level	Name of Institution	Location	Period of Enrollment
Undergraduate Level Education
Graduate Level Education

6. RERERENCES.

Two reference letters should be sent by your referees directly to: [e-mail]

Name & Position

Business ,Telephone, E-Mail and Mailing Address

7. PREVIOUS EMPLOYMENT. Use one line for each position.

Position	Company/Organization	Period of Employment	Responsibilities

8. DECLARATION: I declare that:

a. I am not concurrently holding a Taiwan nationality;

b. I am not an exchange student resulting from an agreement signed between my home institution and any Taiwan university/college;

c. The information I have given on this application is complete and accurate to the best of my knowledge.

Applicant’s Signature Date _____ /_____/_____

Application Guidelines:

1. Complete the Application on-line at: taiwanusalliance.com. All required documents must be at our office not later than 15 Feb. 2012 for early admission and March 31, 2012 for regular admission.. Announcement of scholarship awardees will be made on 22 February for early admission decision and 10 April 2012 for regular admission. For those who indicate a desire for early decision, you will have another chance to be evaluated on April 10^th should the initial decision not be successful.

2. Eligibility Requirement:

a) Citizenship: only U.S. citizens can apply. [ A U.S. passport is essential for traveling abroad. The U.S. passport must be applied at least 3 months before departure. If you don’t have one].

b) Academic Preparation:

*Full-time undergraduate or graduate student at an institution of higher education in the United States.

*Must have a GPA of at least 3.0 on a 4-point scale and be of good moral character.

.

3. Where and When: Training will be based at the National Pingtung University of Education (NPUE) in Taiwan. Study period will be the first week of July and the last week of August, 2012. Six credit units will be awarded by NPUE after completion of the program. Each U.S.student will be assigned a Taiwanese peer to facilitate learning Chinese language and culture.

4. A stipend of NT $25,000 (U.S. $800) per month for two months (July & August) will be awarded to each scholarship recipient. This stipend is to cover tuition, dormitory fees, four excursions, and incidental insurance. Meals are not
included, and you must provide your airfare to and from Taiwan.

5. Health: A student selected for a scholarship is required to have a pre-departure medical examination, the result of which must indicate that he or she is physically and psychologically healthy; the results of a HIV and TB test must be included (valid within 6 months). This medical exam is required for admission to NPUE.

6. Documents required before your application will be considered:

a. Fully completed 2012 TUSA Ambassador Scholarship Application including two essays, 300 words each by on-line application. Send a copy of your student I.D. to  [e-mail].

b. Two letters of recommendation, preferably from your professors.  Ask your professors to e-mail their letters to:  [e-mail].     
7. TUSA contact: [e-mail] and [e-mail]

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