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  1. 1. Summer Programs for High School Students 2010 Application Form >> Return to: Georgetown University Summer Programs for High School Students 3307 M St, NW Suite 202 Washington, DC 20007 Students may apply for programs by completing and mailing this application, or by completing the application online at https://app.applyyourself.com/?id=scsgtu. Program/s applying to: American Politics & Public Affairs, July 18- Journalism Workshop, June 27-July 4, 2010 25, 2010 Law & Society, August 1-8, 2010 College Preparatory Program, June 27-July Leadership & Ethics, June 20-27, 2010 17, 2010 National Security & Counterintelligence, July Environmental Science, July 11-18, 2010 25-August 1, 2010 Fundamentals of Business: Leadership in a Sports Industry Management, July 4-11, 2010 Global Economy, July 11-August 14, 2010 Summer College, Session I, June 6-July 10, 2010 International Relations, July 11-18, 2010 Medicine, July 4-11, 2010 Summer College, Session II, July 11-August 14, 2010 Forensic Science, August 8-15, 2010 YOUR APPLICATION IS INCOMPLETE UNTIL WE HAVE RECEIVED:  An official copy of your transcript (including PSAT/SAT/ACT scores and current grades). Please note that PSAT/SAT/ACT scores are required for students applying to Summer College and Fundamentals of Business.  A 300-word essay answering the question: ―How will this program help me accomplish my academic goals?‖  A letter of recommendation. See form attached.  $50 nonrefundable application fee—check made payable to Georgetown University.  Non-native speakers of English must forward results of the Test of English as a Foreign Language™ (TOEFL) for the purpose of verifying English-language ability. The program requires a score of 550 or above on the written exam or a score of at least 213 on the computer-based exam.
  2. 2. STUDENT INFORMATION: Student name: First MI Last Social Security number: – – Home address: City: State: Zip code: Country: Citizenship: Home phone: ( ) Fax: ( ) Cell phone: ( ) E-mail address: Sex: Male Female Birth date: / / Expected date of high school graduation: Will you be requesting campus housing? Yes No To meet Federal requirements on the collection and reporting of race/ethnicity, would you please take the time to answer the following two questions: Do you consider yourself to be Hispanic/Latino(a)? Yes No In addition, select one or more of the following racial categories to describe yourself: American Indian or Alaska Native Black or African American Asian Native Hawaiian or Other Pacific Islander White PARENT OR GUARDIAN INFORMATION: Name: Address (if different from student): Work phone: ( ) Home phone: ( ) Cell phone: ( ) E-mail address: HIGH SCHOOL INFORMATION: Name of school: Phone: ( ) Address: City: State: Zip code: Country: Have you ever been suspended from high school for any reason? Yes No Are you currently a student in good standing? Yes No 4
  3. 3. Please list your school and community activities. You may attach an additional sheet if necessary. Activity Position held or award Dates How did you hear about this program? Georgetown Web site E-mail Brochure Postcard High school Peterson’s Guide Ad Model UN The Washington Post  The New York Times  The LA Times Advisor Sibling Friend Other Limited tuition-only scholarships based on academic merit are available for exceptional students applying to credit program offerings: S u m m e r C o l l e g e a n d / o r F u n d a m e n t a l s o f B u s i n e s s . The scholarship application is available on the Web at http://summerschool.georgetown.edu/financial.html. Signature of applicant and parent or guardian will signify willingness to abide by the conditions and regulations of Georgetown University and the program if the applicant is selected to participate. Photographs taken while students are enrolled in programs are the property of Georgetown University and may be used for marketing and public relations purposes at the discretion of the university. Signature of applicant: Date: Signature of parent/guardian: Date: Georgetown University is an Equal Opportunity/Affirmative Action Institution in employment and admission.
  4. 4. Summer Programs for High School Students 2010 Recommendation Form >> Return to: Georgetown University Summer Programs for High School Students 3307 M St, NW Suite 202 Washington, DC 20007 To the student: Give this form to a teacher, counselor, or principal—someone who has personal knowledge of your capacity to perform and live in a university environment. Student name: First MI Last Social Security number: – – Program/s applying to: American Politics & Public Affairs College Preparatory Program Environmental Science Fundamentals of Business: Leadership in a Global Economy International Relations Journalism Workshop Law & Society Leadership & Ethics National Security & Counterintelligence Sports Industry Management Summer College Medicine Forensic Science  I waive my right to inspect this appraisal when completed and understand that it will remain confidential.  I do not waive my right to review this document. Signature of applicant: Date: To the recommender: This individual is applying for admission to a Georgetown University summer program. 1. If you have taught the applicant, please indicate course, grade, and year(s): 2. Briefly evaluate the applicant with respect to character, integrity, and any special talents or qualities. Please identify issues about which the student is particularly enthusiastic. In your estimation, does the candidate demonstrate the independence necessary to successfully adapt to a college environment? Attach your appraisal to this form. Please print your name: Position: Name of school: Address: City: State: Zip code: Country: Phone number: ( ) E-mail address: Signature: Date: Georgetown University is an Equal Opportunity/Affirmative Action Institution in employment and admission.

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