May 15 May 29 June 12 June 26

GRAD COLLEGE PREP SUMMER CAMP APPLICATION

July 15-20, 2013

Application deadline June 10^th 2013

PERSONAL INFORMATION

Name: First _________________________________ Last _______________________________

Birth date: ______/______/________ (mm/dd/yy)

Address: _________________________________________________City:_________________________

Home phone:______________________________ Cell phone:_________________________________

Email address: primary __________________________ secondary: _______________________________

UNIVERSITY INFORMATION

Name of the University you are currently attending or attended in the past

_________________________________________________City:________________________________

What is your expected date of University graduation (if applicable)? ____/____/_____ (mm/dd/yy)

Your current work place (if applicable):

YOUR INTENDED MAJOR: ______________________________________

LIST OF COLLEGES YOU ARE PLANNING TO APPLY TO (if applicable):

1. __________________________________________

2. ___________________________________________

3. ___________________________________________

4. ____________________________________________

5. ____________________________________________

WORK EXPERIENCE (if any):

EXTRA-CURRICULAR ACTIVITIES (if any):

TOEFL/IELTS/GRE SCORES (if applicable):

To have your application considered you will need to take diagnostic TOEFL EducationUSA provides at American Corner on a monthly basis. Please choose one of the options

May 15 May 29 June 12 June 26

Estimated camp fee is 15.000 tenge. Partial scholarships MIGHT become available, please check ONE of the boxes below:

I can pay for the camp

The ONLY way I can attend this camp is getting a partial scholarship

SIGNATURE

Signature of applicant:____________________________________ Date__________________________

Дата добавления: 2015-11-16