Education Abroad Winter 2015 Scholarship Application *Complete applications must be submitted on or before the deadline: 5:00pm October 14, 2014 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) Email 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
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 and Photo Authorization/License to Use Form Please include the signed Video and Photo Authorization/License to Use Waiver, indicating your commitment to submit 5 photos and 5 separate one-minute video clips taken while abroad as part of your scholarship reward. These videos must be submitted to the Queens College no later than February 5, 2015. Section VI: Queens College Photo/Video Authorization and Release Form Please include the signed Queens College Photo/Video Authorization and Release Form. 2
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 Winter 2015 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 October 14, at 5:00pm. Thank you for your time and consideration! Recommender s Name: Recommender s Title: Department: Telephone Number: Email: Recommender s Signature: Date: 3
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
Video and Photo Authorization/License to Use This signed authorization indicates your commitment to submit 5 photos and 5 separate one-minute video clips taken while abroad as part of your scholarship reward. What to submit: Upon return, please submit 5 of your favorite photos and short video recordings that, combined, total no more than 5 minutes in length. Video clips and photos must have been taken by or of the scholarship recipient using iphones, digital cameras, or other recording devices; only video clips and photos taken during your study abroad program may be submitted. Video clips and photos may not be digitally or otherwise enhanced or altered. Do not submit offensive or inappropriate video clips or photos. Video clips 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 Your rights: Except as described below, you will retain all rights in your videos. By submitting your videos, you represent that your submission represents exclusively your work and you grant to the City University of New York, including Queens College, the royalty-free, nonexclusive right, in perpetuity to: Use (including display) your videos on the Queens College website in connection with study abroad and/or in support of the college s mission; Include your videos in our Queens College study abroad materials; Use your videos in CUNY s noncommercial communications (including CUNY-related use in news stories, newsletter, displays, web pages, and the like); Provide your videos to other individuals and organizations for noncommercial use (including CUNY-related use in news stories, newsletters, displays, web pages, and the like); Use, in connection with the Office of Education Abroad, of your name, city, state, country of residence, and country of travel in promotions and other publications; and Keep the files provided, and to archive the images on CD or in other electronic forms. We will credit all videos with the recorder s name as provided to us. (Signature) (Date) (Print Name) 5
Scholarship Application Checklist Application Form: Including Section I and II completed 1-2 page essay Official Queens College transcript Recommendation forms and letter Video and Photo Authorization/License to Use Form 6