APPLICATION FOR THE GLOBAL SCHOLARS PROGRAM AT AFRICAN LEADERSHIP ACADEMY

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1 Phone: Campus Address 1050 Printech Ave, Honeydew 2040 South Africa Postal Address Postnet Suite 413, Private Bag X1 Northcliff 2115 South Africa Phone: Fax: APPLICATION FOR THE GLOBAL SCHOLARS PROGRAM AT AFRICAN LEADERSHIP ACADEMY Admission into the Global Scholars Program (GSP) is competitive and contingent upon the review and approval of the global programs selection team. Following submission of the application, you may receive a request for clarification or additional information on behalf of the committee. Submission of the application is not a guarantee of admission. Prior to completing this application, we encourage you to learn as much as possible about African Leadership Academy and its unique approach to training the world s future leaders. The GSP builds on ALA s proven track record in leadership development and is an opportunity for you to engage with other young leaders who share an interest in exploring the future of Africa and the world. As a participant in the program, you will engage deeply with peers from across the globe; you will develop your leadership and entrepreneurial skills; and, you will actively participate in social projects that will help shape Africa s future. Each student selected for the GSP will bring a particular perspective and valuable contributions that will ensure a unique and enlightening experience. To learn more, please visit our website at Be in touch, ask us questions, and encourage your parents/guardians to do the same. Think deeply about how you want to use your experience to make a difference. If you decide this opportunity is for you, take the next step and apply, either through our website or by returning this application via to summer@africanleadershipacademy.org. We are excited about your interest in the Global Scholars Program and look forward to learning more about you, your passions, and all that you will bring to our international community of leaders. APPLICATION INSTRUCTIONS Please fill in the following two components A. Application data form B. African Leadership Academy Code of Conduct C. Financial information D. Short answer questions Applications for the 2015 Global Scholars Program are evaluated on a rolling basis. The selection committee will review and alert applicants of their status within two weeks of submitting the completed application. The selection committee reserves the right to verify or request additional information at any point in the process. In particular, a telephone interview may be required of some applicants. The application process is designed to be rigorous and illustrative of an applicant s interests, motivation and leadership potential. Space in the 2015 Global Scholars Program will be limited and early application is encouraged. Should you be admitted into the Global Scholars Program, a $500 deposit will be required to reserve your place in the cohort. The deposit must be paid within 30 days of your admission notification. The balance of the program fees will be due no later than May 1, EARLY BIRD APPLICATION DEADLINE (10% Discount): December 15, 2014 PROGRAM APPLICATION DEADLINE: March 31, 2015

2 Global Scholars Program Application Page 1 A. APPLICATION DATA FORM STUDENT INFORMATION (Please type or write very clearly.) Surname: Given Names: Gender: Birth Date (Day/Month/Year): Mobile Phone: (+ ) Other Phone: (+ ) Postal Address: Country code Country code Country Passport Country of Issue: PARENT/GUARDIAN INFORMATION Living with: Parent(s) Relative(s) Other Name(s)/Relationship to you: P/G 1 Phone: P/G 1 P/G 2 Phone: P/G 2 SCHOOL INFORMATION: School Name and Location (City/Country): Current Grade Level/Year: What was your most recent grade point average? (Or equivalent?): GSP INFORMATION Which session of GSP will you attend? Session 1: Monday, 29 June Friday, 17 July Session 2: Monday, 13 July Friday, 31 July Session 3: Saturday 25 July Wednesday, 12 August How did you learn about African Leadership Academy and the GSP (please mark all that apply)? Information session / presentation (please specify location): Teacher, principal or counsellor (please list name): Friend, parent, guardian or relative (please specify and list name): ALA/GSP website (please specify how you found the website): Other, e.g. other website, newspaper, magazine, radio (please specify):

3 Global Scholars Program Application Page 2 B. AFRICAN LEADERSHIP ACADEMY CODE OF CONDUCT (read carefully, important!) Students in our program are representatives of their home nations and schools. As such, they are expected to be respectful of all the other students on the program, the staff, and the public. They are also expected to demonstrate open mindedness and enthusiasm for learning. Finally, students must obey African Leadership Academy s Code of Conduct, stated below. Any violation of the Code of Conduct will result in the student s immediate removal from the program. The student will be sent home on the next available flight - at the parents or guardians expense, even if there is one day remaining on the program. 1. Stay on campus. Students are required to remain on the program campus at all times except when accompanied by a staff member or unless granted permission in advance. 2. Have a buddy. On trips, students are committed to a strict adherence to a buddy system. A student is never at any time permitted to go off on his or her own. 3. Don t catch a ride. Students are only permitted to travel in motorized vehicles with program staff. Any instances of riding in an unauthorized vehicle, including taxis or buses, will result in expulsion. 4. No alcohol, tobacco, or drugs. The use of alcoholic beverages, tobacco products, or any other controlled substances is strictly prohibited during the student s time in the program. Use of these products will result in immediate expulsion. Nicotine patches or gum are acceptable. 7. Water safety. Students are not allowed to swim on trips except with the permission and under the supervision of one of the program s trained lifeguards. Students are to obey all rules laid out by the lifeguards under any swimming excursion. 8. Ask for permission. Students are required to ask for permission to take part in activities not specifically authorized or supervised by the program staff. 9. Commitment to program. Students must be committed to the program, from beginning to end. This means students will approach all ALA activities with an open mind and will commit to participating in all aspects of the program. We have read and understood the African Leadership Academy Code of Conduct, and the student agrees to adhere to these rules at all times if accepted to the program. Parent/Guardian Signature: Parent/Guardian Name: Student Signature: Student Name:

4 Global Scholars Program Application Page 3 C. FINANCIAL INFORMATION 1. Cost: The cost of attendance for the 2015 Global Scholars Program is US$4,200. This includes: tuition, all meals and accommodation on campus, airport and local transportation to experiential sites, and all entrance fees associated with program field trips. It does not include: Round-trip transportation to South Africa, visa fees where applicable (not required for EU, UK, and US citizens), or student spending money. 2. Early Bird Special: Admission to the GSP is competitive and space is limited. Applications will be reviewed on a rolling basis beginning, and students are encouraged to apply early. All applications submitted prior to December 15, 2014 will be eligible to receive a 10% discount on program fees. In order to receive the Early Bird Discount, full payment of the program fees must be received by January 31, 2015 through any of the methods listed below. 3. Full Program Payment: Upon application to GSP, a $500 deposit is required in order to hold a student s place in the program. Deposits are due on submission of the application and can be paid through any of the methods listed below. Full payment of the program fee balance must be received before May 1, Payment methods: you can pay via credit card using our secure online system. You can transfer directly into the Academy s bank account using the details below providing your surname as the reference: Account name: African Leadership Academy Bank Name: Standard Bank SWIFT Code: SBZA ZA JJ Branch Name: Sandton Branch Code: Account Number: Please note that there is no financial intermediary.

5 Global Scholars Program Application Page 4 Name: Phone/ D. SHORT ANSWER QUESTIONS List any extracurricular activities including notable achievements: In 100 words or fewer, what is your motivation to join Global Scholars Program? What do you hope to gain from your experience? List any activities you participated in at school or in your community and any leadership positions held. Describe yourself. You may use words, pictures, symbols, equations anything you would like. Note: You may attach an additional page if you wish. I hereby certify that all information is truthfully and accurately presented and my work alone.

6 Global Scholars Program Application Page 5 Signature: Date: