Educationusa academy 2020 Scholarship Application Form Full name

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 [e-mail] by February 20, 2020.