WITNESS Please submit a separate personal statement if applying for multiple internships.

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1 Name: University of Connecticut Human Rights Institute Undergraduate Human Rights Internships Cover Sheet Application deadline: March 1 Application Checklist: Application Form Personal Statement Budget Narrative Letter of Recommendation Unofficial Transcript Resume Please submit your application in PDF via to humanrights@uconn.edu Please name your document in the following format: Lastname.firstname.internshipplacement.2016 Incomplete applications will not be considered. Students are welcome to apply for multiple internships. Please submit a separate personal statement for each program to which you are applying. Please indicate the internship(s) for which you wish to be considered: Business and Human Rights Resource Center Center for Justice and International Law (CEJIL) Croatian Mediation Association & Center Freedom House International Criminal Court of the Former Yugoslavia Lawyers Without Borders Net Impact Social Accountability International WITNESS Please submit a separate personal statement if applying for multiple internships. For questions or inquiries, please humanrights@uconn.edu or call (860)

2 University of Connecticut Human Rights Institute Undergraduate Human Rights Internships Application Form Name: Student ID #: Date of Birth: Permanent Street Address: City: State: Zip Code: Local Street Address: City: State: Zip Code: Telephone: ( ) I am a Human Rights: Major Minor Expected Graduation: What languages do you speak/read? Foreign Language Courses Taken: Course # Course Title Semester Are you a U.S. Citizen? Yes No All of the internships require the selected students to move to the respective city where the agency is located. You would be responsible for obtaining your own lodging. Are you willing to move for the length of the internship? Yes No Are you eligible or qualified for financial aid? Yes No Do you have substantial financial need, even if you are not eligible for financial aid, which can be demonstrated to the Award Committee if requested? Yes No Emergency Contact: Relationship: Phone Number: ( ) Cell Phone: ( ) Application continued on next page.

3 Anticipated Budget Please complete this budget to assist you in thinking about the expenses associated with the internship and whether this is something you can do financially. Travel (to relocate and daily commute) Living Expenses (rent, utilities, food, etc.) Registration/Tuition for 3 credits (N/A for ICTY) Other (please describe): Total HRI Stipend Self Family Other (i.e., financial aid, other awards) Total In addition to this application, please submit the following: 1. Personal Statement: Please describe your plans for your human rights internship and how this award will assist you in achieving your goals. Your statement should include information on your interest in human rights and how the internship experience fits with your future career plans. Your statement should not exceed 1,000 words. Please submit a separate personal statement for each program to which you are applying. 2. Budget Narrative: The purpose of the budget narrative is to supplement the information provided in the budget spreadsheet to demonstrate you have considered the costs associated with your internship. Together, the budget narrative and budget spreadsheet should provide a complete financial and qualitative description that supports the requested funds. Please use the budget narrative to provide a description of your budget. 3. Letter of Recommendation: Please have one letter of recommendation written on your behalf from an instructor or mentor who has known you for at least one year. The reference letter must be submitted in a sealed envelop and include the name, address, and phone number of the referee. 4. Unofficial Transcript: Please enclose an unofficial copy of your University of Connecticut academic transcript. 5. Resume: Please enclose a resume that includes current and previous employment, including military experience, part-time work, and summer or other temporary positions. Your resume should also list your involvement in extracurricular activities, such as organizations, clubs, sports, and campaigns, while attending the University of Connecticut. I attest that the information in this application and its supporting materials are true and accurate to the best of my knowledge. Signature Date

4 Budget Narrative Travel: Living Expenses: Registration/Tuition/Study Abroad Fee: HRI Stipend: Self: Family: Other: I anticipate being able to afford the costs associated with the internship if I am selected.

5 Sample Budget Narrative Travel: I expect the expenses to relocate to include travel to New York City and daily commuting. New York is 140 miles from my house, so to move there and back home will cost $ I will purchase two 30-day unlimited Metro cards for a total cost of $208. My total travel expenses are anticipated to be $ (Please consult for the current mileage rate. Mileage should be calculated at current mileage rate x total miles roundtrip x days at internship). Living Expenses: I estimate subletting an apartment in Brooklyn for the 8 weeks on my internship for $1,100 per month. I hope to find a place that includes utilities. I anticipate spend $50 per week on groceries. My total living expenses are anticipated to be $2,600. Registration/Tuition/Study Abroad Fee: Since I will be taking the internship seminar over the summer, I will be charged for three credits which typically costs $1,175 according to the Summer Session website. HRI Stipend: The HRI stipend for this internship is $5,000. Self: I will be able to contribute $100 towards my internship expenses. Family: My parents are willing to contribute $500 toward my internship expenses. Other: I anticipate being able to afford the cost of the Witness internship if I am selected.