Educationusa academy 2020 Scholarship Application Form Full name



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EducationUSA Academy Scholarship Application Form 2020




EducationUSA Academy 2020 Scholarship Application Form
Full name: ______________

Last Name First Name MI


Date of Birth (DD/MM/YY): __________________________________________________________________
City and country of birth: ____________________________________________________________________
Home address: _____________________________________________________________________________
E-mail: _____________________________________
Telephone number: _________________________________________________________________________
School number/name: _______________________________________________________________________
Year of study/Grade: _________________________________________________________________________
If available, TOEFL/IELTS score from within past 6 months: __________________________________________
If available, estimate of English proficiency on CEFR scale: ___________________________________________
2020 Host Institutions and Program Dates:


#

Host Institution

Start Date

End Date

1

Boston University

July 13

July 31

2

Diablo Valley College

July 13

August 7

3

Embry-Riddle Aeronautical University

June 14

July 2

4

Northwestern University

July 5

July 25

5

St. Cloud State University

July 5

July 24

6

St. John’s University

July 5

July 18

7

Syracuse University

June 29

August 9

8

Temple University

July 5

July 25

9

University of Colorado Boulder

July 2

July 24

10

University of Tennessee Knoxville

July 6

August 3

11

University of Madison Wisconsin

July 1

July 19


Placement: Please list up to three institutions in order of preference*:
1._______________________________________________________________________________

2. _______________________________________________________________________________


3. _______________________________________________________________________________
*Please note that we will attempt to accommodate placement requests. However, we cannot guarantee placement at particular host institutions.
Personal Essay: 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 20, 2020.




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