Section I: Basic Student Information. Name. Indicate program for which you are applying. CUNY First ID. Date of birth. City and country of birth

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1 Education Abroad Summer 2014 Scholarship Application *Complete applications must be submitted on or before the deadline: 5:00pm March 21, 2014 GPA Requirement: 3.0 or above Section I: Basic Student Information Name (Last) (First) Indicate program for which you are applying CUNY First ID Date of birth City and country of birth Do you have a current passport? Do you receive financial aid from Queens College? Language skills (other than English) Address Current mailing address (Street Address) (Town) (State) (Zip Code) Daytime phone ( ) Evening ( ) Name of Emergency Contact Phone number of Emergency Contact Section II: Educational Background Major Minor College year Queens College GPA Career Goals 1

2 Section III: Essay Component Please attach a 1-2 page double-spaced typed essay to your application. This essay should be in Times New Roman 12 point font. In your essay you must address: Reasons why you want to go abroad; How the program, in particular, will impact you personally, academically, and professionally; Your financial need of the scholarship and how it will help you. Section IV: Transcript Please include an official Queens College transcript with your application. Section V: Video Clips Each awardee of a scholarship is required to submit to the 20 minutes of video clips taken by or of the awardee while participating in the study abroad program. Please include with your application the signed Video Clip Commitment and Use Authorization form, indicating your agreement to submit the video clips on your return to the United States and authorizing CUNY (including Queens College) to use the clips as it deems appropriate. What to submit: Upon return, please submit short video recordings that, combined, total no more than 20 minutes in length. Videos must have been taken by or of you using iphones, digital cameras, or other recording devices; only videos taken during your study abroad program may be submitted. Videos may not be digitally or otherwise enhanced or altered. Do not submit offensive or inappropriate videos. Videos should showcase the study abroad experience in all its dimensions. Consider lighting and framing of video clips. Creativity is welcomed and encouraged. Suggestions for video clips: Inside the classroom Dorm/housing environment Before trip flight departure/after trip flight departure Interviews (with students, with locals) Video diary detailing experience Narrations On excursions Diverse settings 2

3 Recommendation Form To the applicant: Please complete the top part of the form below: Applicant s Name I waive my rights to have access to this recommendation form. I do not waive my rights to have access to this recommendation form. *Note: Recommendation Letter MUST be from a Queens College Professor To the Recommender: Thank you for taking the time to recommend the applicant for the opportunity to receive an Education Abroad scholarship for one of our Summer 2014 Programs! Your recommendation will have two parts. (1) A letter on official letterhead indicating: a. how long, and under what circumstances, you have been familiar with the candidate and his/her academic work, and b. your evaluation on why you would recommend this student for this experience. (2) Your evaluation using the form on the following page. Please attach the form to your letter of recommendation and place both in a sealed envelope with your signature across the seal. This envelope can be given to the candidate who is responsible for submitting the recommendation with their application packet, due by Friday, March 21 st, at 5:00pm. Thank you for your time and consideration! Recommender s Name: Recommender s Title: Department: Telephone Number: Recommender s Signature: Date: 3

4 Please evaluate applicant s suitability for participation in the chosen education abroad program. Excellent Good Fair Poor No opportunity to observe Level of maturity Level of responsibility Ability to adapt to new or unstructured circumstances Ability to relate well to others Open-mindedness 4

5 Video Clip Commitment and Use Authorization By signing this Video Clip Commitment and Use Authorization, I hereby agree that: (1) As a condition of receiving a study abroad scholarship, if I am awarded one, I will submit to the Queens College 20 minutes of video clips taken by or of me while participating in the study abroad program; (2) Any video clips I submit will be solely my own work, or if they are videos of me, will be works that I own or have the unrestricted right to use and license; (3) CUNY, including Queens College, shall have the right and license to use, reproduce, modify, exhibit and/or distribute such video clips, in whole or in part, in any manner or medium now known or hereafter developed, an unlimited number of times in perpetuity throughout the world, for any purpose that CUNY may deem appropriate, including without limitation promotional or advertising efforts; and (4) Except as described in (3) above, I will retain all rights in and to the video clips. I understand that Queens College will use reasonable efforts to credit me when using the video clips. I am 18 years old or older. (Signature) (Date) (Print Name) 5

6 Scholarship Application Checklist Application Form: Including Section I and II completed 1-2 page essay Official Queens College transcript Recommendation forms and letter Video Clip Commitment and Use Authorization (signed) 6

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