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PART I: Personal Information |
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| First Name:
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Last Name:
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| Student Number:
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| Major:
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Minor:
Campus:
Seattle
Tacoma
Bothell
Other/Non-Matriculated
Anticipated Graduation Quarter and Year:
Spring
Summer
Autumn
Winter Year:
Birthdate: mm/dd/yyyy
Must format as Month/Day/Year. For instance 05/22/1987 |
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Current Address |
Permanent Address |
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Email: |
Please use your complete UW email address if available. |
Telephone: |
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| Emergency Contact Name:
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| Emergency Contact Phone:
Relationship to Student:
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Class Standing
Freshman
Sophomore
Junior
Senior
5th Year (+) Senior
Graduate Student
Post-Baccalaureate
Non-matriculated (Please Note: Non-matriculated participants who will not be enrolled at the UW during the quarter of their program [e.g. Fall 2009 for early fall programs] will be subject to an additional $200 fee, and must pay the full program fee up front.) |
| Current GPA:
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Gender
Male
Female |
Are you a U.S. Citizen?
Yes
No
If you are not a U.S. citizen, please enter your citizenship
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| Are you eligible for financial aid?
Yes
No |
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| PART II: Confirm Program |
Guatemala
Instructor: Catherine Carr
Summer Nursing Program |
| Are you applying to other Exploration Seminars?
Yes
No |
| Which other programs?
(separate applications required for each) |
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| PART III: Essay |
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Question:
Please reflect and write a personal statement on the following questions.
You might find it easier to formulate your
response first using a word processing program
and then cut-and-paste the answer into the
on-line application form.
Please write a short response (of 500- 1000 words) answering the following questions. In your response, consider what strengths you might bring to the program and why the Exploration Seminar program to which you are applying would want to have you along as a student and member of the group.
- why did you pick this program in particular?
- how does this program suit your academic goals?
- how does this program suit your personal interests?
- in what ways will you contribute to the a) academic, b) cultural and c) group experiences?
- what do you hope to learn and gain from this experience?
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