Youth Exchange and Study (YES) Scholarships
TOMORROW’S LEADERS SCHOLARSHIP PROGRAM
منحة قادة الغد للدراسة الجامعية
The deadline to apply is December 31, 2013
You may apply using the paper application below or online at tl
Instructions for submitting the application by mail or email are on the last page.
The Tomorrow’s Leaders Scholarship Program is a U.S. Department of State Middle East Partnership Initiative (MEPI) initiative for capable and highly motivated high school seniors in the Middle East and North Africa from underserved backgrounds.
The scholarship includes: travel, academic fees for four years of university at the American University of Beirut, the American University in Cairo, and the Lebanese American University, accident and sickness insurance, housing, and a monthly allowance.
ELIGIBILITY REQUIREMENTS:
• Current high school senior or applicant who graduated from high school in 2012 or 2013;
• A citizen or national of Syria, including refugees living outside of Syria;
• Strong academic credentials;
• Proficiency in written and spoken English with a minimum Institutional TOEFL (ITP) score of 425 (or equivalent on a similar test) that is less than two years old; NOTE: The TOEFL test will be arranged by AMIDEAST for qualifying applicants.
• Maturity, flexibility and leadership potential;
• Demonstrated desire to work towards the development of a democratic society in Syria
• Ability to start the program in August/September of 2014.
Note: American citizens are not eligible
REQUIRED DOCUMENTS:
Please review the checklist below before submitting your application to ensure that you have included all the required documents
• Complete and signed Application
• Two or three recommendation forms (use form at end of this application)
• Year 10 and 11 school grades
• Year 12 if graduated in 2012 or 2013
• Three essays
• Supporting financial document(s) (bank statement, etc).
Photo
• Extracurricular activities and other required documents.
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First Name: Middle Name: Last Name: ____________
Gender: Male Female
Birth Date: Month: ___ Day: ___ Year: ___________ City of Birth: _______
Country of Birth: Country of your residency: __________________________
Do you have another nationality? Yes No If yes, which one? _____________
Are you a U.S. citizen? Yes No
Do you or any of your immediate family members (father, mother, brother or sister) have legal permanent residence status (green card) for the U.S., hold a U.S. residency visa or have a green card application currently pending? Yes No
Current Address:
Street Address: __________________
Address line 2: __________________
City: ______ Country: ______
Home Phone: _______ Mobile: _____ Fax: _____________
Email: _______
Permanent Address (if different than current address)
Street Address: __________________
Address line 2: __________________
City: ______ Country: ______
Home Phone: _______ Mobile: _____ Fax: _____________
Email: _______
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Father’s Data:
First Name __________ Middle Name _________ Last Name _______
Occupation: _______ Company Name: ___________________________
Street Address: __________________
Address line 2: __________________
City: ______ Country: ______
Home Phone: _______ Mobile: _____ Fax: _____________
Email: _______
Mother’s Data:
First Name __________ Middle Name _________ Last Name _______
Occupation: _______ Company Name: ___________________________
Street Address: __________________
Address line 2: __________________
City: ______ Country: ______
Home Phone: _______ Mobile: _____ Fax: _____________
Email: _______
Do you have any relatives currently enrolled or who have graduated from AUB, LAU, or AUC? Yes No
If yes, please provide the information for each relative who is enrolled or who has graduated from any of these three universities: _____________
Do you have or have had any relatives employed by AUB, LAU, or AUC?
Yes No
If yes, please provide the information for each relative who is or was employed by any of these three universities: _____________ ______________
Information of a person who can be contacted in case of emergency:
Full Name: ___________________________________________________________
Relationship: __________________________________________________________
Home Address:
Street:
City: Country:
Home Phone: Mobile: Fax:
Email: _____________________________
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Indicate your choice of university, major and concentration or emphasis (if applicable) in order of preference. Select up to three from the options below:
First Choice:
Select a University:
American University of Beirut
Select a Major:
• Political Science/Political Studies*
• Public Administration*
• History
• Anthropology
• Sociology
• Psychology
• Communication and Media Arts
• Economics
• Philosophy
American University in Cairo
Select a major
• Political Science/Political Studies*
• International Affairs*
• Middle East Studies*
• Multimedia Journalism*
• History
• Anthropology
• Sociology
• Psychology
• Communication & Media Arts
• Film
• Visual Arts
• Theater
• Economics
• Philosophy
• Management of Information & Communication Technology
Lebanese American University
Select a major
• Political Science/Political Studies*
• International Affairs*
• Journalism*
• Psychology
• Radio/Film/TV
• Economics
Majors followed by the (*) sign and a number require more than120 credits for graduation (the number indicates the number of credits needed for graduation). Students will only be accepted to these majors if they meet the additional requirements of that major (such as prerequisite science classes) and if they do not need pre-academic English courses (students with a TOEFL iBT score of under 62 or equivalent may require pre-academic English).
Have you previously applied for admission at any of the three universities, AUB, AUC, or LAU?
If yes, please complete the information below:
Name of the university: _______________________________________________________
Month/Year applied: _________________________________________________________
Are you applying to any other universities or programs?
If yes, please complete the information below:
Name of the university: _______________________________________________________
Program : __________________________________________________________________
Secondary School Information
Complete add school and complete the information for each high school or secondary school where you attended your first, second, and third secondary years (sophomore, junior, and senior years in U.S. style high school)
School Year: _________________________________________________________________
School Name: _______________________________________________________________
School City: _________________________________________________________________
From (month/year): __________________________________________________________
To (month/year): _____________________________________________________________
Graduation Date: ____________________________________________________________
Division: Arts Sciences Math Others: __________________
Type of School: Public Private
Name of government secondary school certificate or high school diploma held or expected to be received.
(For example: Baccalaureate, Al-Thanawiyyah Al-Amma, Tawjihi, International Baccalaureate (IB))
Name of Certificate/Diploma in English: __________________________________________
Date Received or Expected: ____________________________________________________
If Lebanese Baccalaureate Part II, please indicate type of certificate
Literature & Humanities General Sciences Life Sciences
Sociology and Economics Others: _____________________________________
If Advanced Level GCE, IB, or Advanced Placement, please click add subject to specify subjects passed (or expected to be passed) and level:
Subject: _____________________________ Level: ___________________________
Have you ever been on suspended or placed on probation at any school?
Yes No
If yes, please write an explanation on a separate paper. If yes and the reason for suspension/probation was not for academic reasons, you must also provide an explanation letter from the institution‘s chief student affairs officer. Your application is considered incomplete without this information.
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Add Employment of Internship information:
Company: __________________________________________________________
City: _______________________________________________________________
Position: ____________________________________________________________
From (month/Year): ___________________________________________________
To (month/year): ______________________________________________________
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| |
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Have you ever had a serious illness? Yes No
If yes, please specify illness and year
Illness 1: ____________________________________ Year: _________________
Illness 1: ____________________________________ Year: _________________
Illness 1: ____________________________________ Year: _________________
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Please answer all the questions in the following section and attach any supporting financial documents (such as a bank statement).
Have you ever worked? Yes No
If yes, please provide employment and describe the work, your pay, and the reason for working.
Job: _____________________________________________________________________
Salary (amount in U.S. Dollars): ________________________________________________
Reason for working: _________________________________________________________
How many people, including yourself, depend on the income of your parents for daily living expenses: _________________________________________________________________?
Add family member and list all of your family members living at home and their current employment status:
Name: ____________________________________________________________________
Relationship: _______________________________________________________________
Employment status: _________________________________________________________
Job title: ___________________________________________________________________
Please indicate your family’s 2012 household income and household expenses below. Enter amounts per year and converted to U.S. dollars:
Income in 2012
Father/Guardian: ____________________________________________________________
(net) (annual wages, salaries, & pensions)
Mother/Guardian: ___________________________________________________________
(net) (annual wages, salaries, & pensions)
Your work income: ___________________________________________________________
Business: __________________________________________________________________
Farm: ______________________________________________________________________
Real Estate Holdings: _________________________________________________________
Securities (Stocks and Bonds): __________________________________________________
Other Members of the Household: ______________________________________________
Other: _____________________________________________________________________
Other (please specify): ________________________________________________________
Total Income: _______________________________________________________________
Expenses in 2012:
Yearly household expense (rent, food, clothes, transport etc): _________________________
Medical Expenses (non-refundable): _____________________________________________
Taxes: _____________________________________________________________________
Loans or Installments: _________________________________________________________
Education tuition for dependents: _______________________________________________
Other expenses: _____________________________________________________________
If other expenses please specify: ________________________________________________
Does your family rent or own your home or apartment?
Rent Own Both
If you answered "rent", please indicate annual rate for rent converted to U.S. dollars:
__________________________________________________________________________
If you answered "own", please indicate current home value:
___________________________________________________________________________
How many cars do your family own?
Make (Nissan, Chevrolet…etc): __________________________________________________
Year: ______________________________________________________________________
Owner: _____________________________________________________________________
Values in US dollars: ___________________________________________________________
Do you have any financial resources that have not been mentioned above?
Yes No
If yes, please describe in detail:
Will there be a significant increase or decrease in your family’s income next year?
Increase Decrease None
If you answered "Increase" or "Decrease", please explain
___________________________________________________________________________
___________________________________________________________________________
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Where DID YOU hear ABOUT Tomorrow’s Leaders program? (Check ALL boxes that apply)
AMIDEAST Website Friends/Relative
High school teacher Flyer/Poster
Radio Other (please describe): ___________________________
Facebook
Newsletter
Have you participated in any MEPI or U.S. Department of State programs, such as the English Access Microscholarship or YES Programs…etc.?
Yes No
If yes, please add the program and specify these programs:
Program name: ______________________________________________________________
City/Country: ________________________________________________________________
From (month/year): __________________________________________________________
To (month/year): _____________________________________________________________
If you were not studying last year, please describe what you were doing:
___________________________________________________________________________
___________________________________________________________________________
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Please list all extracurricular activities, hobbies and volunteer services in which you have participated. Please state if you have received any awards, or if you have any outstanding achievements in these activities. Start with the most recent activities. You can use a separate sheet if needed. Please be sure to highlight any leadership roles.
Activity: ____________________________________________________________________
Number of hours: ____________________________________________________________
From (month/Year): __________________________________________________________
To (month/year): _____________________________________________________________
Award/Certification Received: __________________________________________________
Reason for receiving award: ___________________________________________________
Award Received Date: _________________________________________________________
Leadership Role in Activity: _____________________________________________________
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If you have taken any of the tests below, please list your highest scores in each of the tests.
|Testing Information |Date taken or to be taken |Score(s) |
| | |Bottom of Form |
|Top of Form | | |
|TOEFL | | |
|(specify: iBT,CBT, PBT, or ITP) | | |
| | | |
|Bottom of Form | | |
|SAT I | | |
|(Critical Reading, Writing, and Mathematics scores) | | |
|________________________________ | | |
|SAT II | | |
If selected for a Tomorrow’s Leaders scholarship, how would you hope to use your education to contribute to the development of a democratic Syria?
(write your answer below or type on a separate sheet of paper and attach)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
How would this educational opportunity contribute to your ability to become a future leader in Syria?
(write your answer below or type on a separate sheet of paper and attach)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
______________________________________________________________________________________________________________________________________________________
___________________________________________________________________________
______________________________________________________________________________________________________________________________________________________
___________________________________________________________________________
Are you currently living in Syria?
Yes No
If you are not currently residing in Syria, please describe below when you left Syria, where you went, and what you have been doing since leaving Syria
___________________________________________________________________________
___________________________________________________________________________
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Please answer the following essay questions on a separate sheet of paper and attach to the application.
Essay 1 * (required): This scholarship program is called “Tomorrow’s Leaders.” Describe in 250-300 words how you envision playing a leadership role at the university and after you graduate.
2. Essay 2 * (required): In 250-300 words, explain why you have chosen your planned field of study, why this field of study is important to you or your country, and how you plan to use the education you will gain after you graduate
3. Essay 3 * (required): Thinking about your future goals, please describe in 250-300 words what you see yourself doing 5 years, 10 years, and 20 years after graduation.
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| |
|I/ We certify that the information provided in this application about the academic and personal |
|information of the applicant is accurate and complete. I/ We grant AMIDEAST, AUB, AUC, LAU, |
|and MEPI permission to review, as needed, all academic and disciplinary records and to contact |
|all individuals who provide references in support of this application. |
|Withholding information, misrepresentation, or forgery of the presented documents renders me, |
|the applicant, subject to immediate ineligibility in the Tomorrow’s Leaders program and dismissal |
|from the university; and subjects me to all applicable legal penalties. |
|I am aware that it is my responsibility to confirm and update any changes in my application file, |
|and that all materials and documents submitted become the property of AMIDEAST and/or the |
|universities, and that applicants accepted or rejected have no right to claim any of these documents. |
|The applicant and parent or legal guardian hereby declare that the applicant will comply with all |
|university policies, requirements and regulations, including the university’s principles of academic |
|integrity. |
|Note: If applicant is under 18 years of age, the parent or legal guardian must also sign the application |
Name of applicant: ___________________________________________________________
Signature: __________________________________________________________________
Date: ______________________________________________________________________
If Applicant is under 18:
Name of legal guardian: _______________________________________________________
Signature: __________________________________________________________________
Date: ______________________________________________________________________
Please return application and supporting documents to AMIDEAST/Lebanon :
|In Person: |
|Beirut Central District, Bazerkan Building, First floor, Nijmeh Square, |
|Next to the Parliament Beirut |
|By Mail: |
| P.O. Box 11-2190 Riad El Solh, Beirut 1107 2100 |
| By E-Mail: |
| lebanon@ |
|Please direct questions to: lebanon@ or Tel: +961-1-989901 ext 162 |
Tomorrow’s Leaders Scholarship Program
RECOMMENDATION FORM
This recommendation for must be completed by a teacher under whom the applicant has studied or the principal of a school the student has attended.
PART I: To the Applicant: Please complete Part I of this form before delivering it to your recommender.
Name of Applicant: ________________________________
Home Country: ________________________________
Desired Field of Study: ________________________________
PART II: To the Recommender: Please read the scholarship summary and complete the form and written evaluation.
The Tomorrow’s Leaders Scholarship Program is funded by the U.S. Department of State’s Middle East Partnership Initiative (MEPI) and is directed towards capable and highly motivated high school seniors in the Middle East and North Africa (MENA) region who are from underserved backgrounds. The program will provide four-year university scholarships and internship opportunities at American University of Beirut, the American University in Cairo, and the Lebanese American University to students who have the potential to become leaders. The primary objective of MEPI's Tomorrow's Leaders Scholarship Program is to build a cadre of university-age leaders who are civic-minded, intellectually able, and professionally skilled, and who will become the community, business, and national leaders of the future. The program intends to nurture leadership skills and the spirit of civic engagement and volunteerism among outstanding university-age students.
Eligible students include men and women who represent the region’s cultural, religious, and geographic diversity and show leadership potential. These students are from socio-economically disadvantaged backgrounds who could otherwise gain admission to, but would be unable to afford, four years of college.
Name and Title of Recommender: ________________________________
Contact information (please include e-mail): ________________________________
How do you know the applicant? ________________________________
How long have you known the applicant? ______ Months ______Years
How do you rank the applicant among others students you have taught?
• Top 5% [pic] Top 10% [pic] Top 25% [pic] Other %
Using the chart below, please rate the applicant in comparison with other students you have known.
Written Evaluation: Please provide a typed, candid evaluation (English or Arabic) of the applicant's past academic performance and ability to pursue and successfully complete a program of study in the proposed field. Please state any special qualities, characteristics, or achievements that distinguish the applicant. The universities that will review this student's application will pay considerable attention to your statement and specifically to the applicant’s leadership ability. Therefore, please be as complete and detailed as possible in your evaluation. You may add or substitute a letter on a separate sheet of paper if necessary.
Signature: __________________________________
Date: ____________________________
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-----------------------
ATTACH
RECENT PHOTO OF STUDENT
APPLICANT HERE
Tomorrow’s Leaders Application 2014
Personal Data
Family Information
Academic Program Information
Employment & Internships
Health Information
Financial Information
Additional Information
Personal Interests, Extracurricular, and Volunteer Activities
Testing ___________________________________________________________________________
Information
Essay Questions
Signature
Information
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