1. TRANSATLANTIC OUTREACH PROGRAM
A PUBLIC/PRIVATE PARTNERSHIP
2012 STUDY TOUR APPLICATION FORM
EFFECTIVE: September 15, 2011
THE TOP STUDY TOURS ARE OFFERED THROUGH THE SUPPORT OF ITS PARTNERS:

2. 2012 TOP APPLICATION FORM FOR PARTICIPATION IN A STUDY TOUR TO GERMANY
PLEASE READ THE “STUDY TOUR FAQ” BEFORE COMPLETING THIS FORM
SELECT THE DATES DURING WHICH YOU ARE ABLE TO TRAVEL IN 2012:
(You are encouraged to select as many of the dates as possible. You may also rank the dates by order of preference.)
RANK: RANK: RANK: RANK:
JUNE 15 - JUNE 30 JUNE 29 - JULY 14 JULY 13 - JULY 28 JULY 27 - AUGUST 11
Directions: Use Adobe Acrobat Reader software to complete and print PARTS I, II, III, and V of this form.
Attach the items listed in PART IV and submit your entire application packet by POSTAL mail. The application deadline is February 6, 2012.
Failure to complete every aspect of this form constitutes an incomplete application.
PART I
NAME:
(Title: Dr./Ms./Mrs./Mr.) (First/Middle/Last Names as they appear on your passport if you have one.)
HOME ADDRESS:
(Street)
(City, State, Postal Code, Country)
E-MAIL ADDRESS:
(Primary e-mail address that you check regularly from home and from work.)
PHONE NUMBER (HOME/CELL):
(Indicate whether this is a home or cell phone number.)
JOB TITLE:
(Job Title / Teaching Assignment (Example: elementary social studies, AP World History, Curriculum Supervisor, etc.)
GRADE(S) TAUGHT:
(Example: K-6, 7th, 11-12th, University Methods Professor, etc.)
SCHOOL / EMPLOYER:
WORK ADDRESS:
(Street)
(City, State, Postal Code, Country)
WORK PHONE:
APPLICATION FORM CONTINUED ON NEXT PAGE

3. QUESTIONS? CALL (202) 289-1200 OR E-MAIL TOP@WASHINGTON.GOETHE.ORG
PART II
Do you have a valid passport? YES NO (It is recommended that you begin the process of obtaining a passport.)
Date of Birth: Month (MM): Day (DD): Year (YYYY):
Disabled? NO YES (Please attach a brief description.)
In your honest self-assessment, do you believe you are physically healthy enough to successfully complete this study tour? YES NO
(You should be healthy enough to travel by air, be able to manage your own luggage, be able to walk up to several miles per day, and it is recommended that you be
able to confidently ride a bicycle. If you cannot ride a bicycle or are physically disabled, alternative arrangements may be made for you.)
PART III
Have you applied for a TOP study tour in the past? YES NO If YES, what year(s)?
How many times have you traveled outside North America for professional development reasons in the past five years?
Would you consider yourself to be an experienced workshop leader? YES NO
Have you led a “TOP” workshop in the past? YES NO
Have you led a “TOP” workshop since May 1, 2011? YES NO
Is your school a “GAPP” school? GAPP Don’t Know
Is German offered at your school as a foreign language? YES NO
PART IV (Attachments)
1. Attach an official letter from your direct supervisor on letterhead verifying 1) Your current employment status as an educator of
social studies in some capacity, and 2) The likelihood of you maintaining this status in 2012 and beyond.
2. Attach one (and only one) letter of recommendation from someone other than your direct supervisor. It is recommended that this
letter be written specifically for this application.
3. Attach a Résumé (Curriculum Vitae) that specifically highlights specific contributions to Social Studies education. For example,
list all in-service training workshops you have led (not attended) as well as any relevant awards, grants, lesson plans, curriculum
guides, textbooks, publications that you have written, etc. Please carefully document any workshops you have led, indicating
dates, subjects, etc.
Please remember that quality is regarded higher than quantity.
Please limit your attachments only to those items requested above.
NOTE: Applications will be accepted from individuals in all 50 U.S. states and Canada without regard to gender, race, religion, age, sexual orientation,
disability, etc. Team applications (from married/unmarried couples, family members, etc.) are not accepted. Study tour groups may be formed based on
job type, subject/grade level taught, areas of interest, etc. to ensure a productive and cohesive team.
APPLICATION FORM CONTINUED ON NEXT PAGE

4. QUESTIONS? CALL (202) 289-1200 OR E-MAIL TOP@WASHINGTON.GOETHE.ORG
PART V (ESSAY)
1. Attach a one-page essay (10-point font, single-spaced) addressing the following question: Why do you want to participate on a
study tour to Germany? (You are encouraged to reference current events in your answer.)
APPLICATION FORM CONTINUED ON NEXT PAGE

5. QUESTIONS? CALL (202) 289-1200 OR E-MAIL TOP@WASHINGTON.GOETHE.ORG
PART V (ESSAY)
2. Attach a one-page essay (10-point font, single-spaced) addressing the following question: What steps will you take to convey the
knowledge learned on the study tour to your students and colleagues? (Please be as thorough as possible in your reply.)
APPLICATION FORM CONTINUED ON NEXT PAGE

6. QUESTIONS? CALL (202) 289-1200 OR E-MAIL TOP@WASHINGTON.GOETHE.ORG
PART V (SHORT ANSWER)
3. Attach a short description of how you first learned about the Transatlantic Outreach Program / the opportunity to participate in a
study tour to Germany. For example, did you learn about TOP from the newsletter? By attending a TOP workshop at an educator
conference? By word of mouth? By other means?
By signing below, I acknowledge
1. That the information provided herein is true, correct, and complete to the best of my knowledge and belief,
2. That I have read and understood the “Study Tour FAQ,”
3. That if accepted by the Transatlantic Outreach Program, I owe a $350.00 USD refundable deposit, and
4. That if accepted, I am responsible for carrying out certain post-tour tasks to convey the knowledge learned to my students and colleagues.
Signature:
APPLICATION PACKET SUBMISSION BY MAIL
Use the buttons below to SAVE and PRINT this form.
ADDRESS FOR SUBMISSION:
2012 TOP STUDY TOUR APPLICATION
GOETHE-INSTITUT WASHINGTON
812 7TH STREET NW
WASHINGTON, DC 20001
SAVE AS... PRINT...
CLEAR DOCUMENT (DATA WILL BE LOST)
DEADLINE: COMPLETE PACKET MUST BE RECEIVED BY FEBRUARY 6, 2012