Irish American Scholar Program – 2006-2007 Application Form

 

Name: __________________________________________Telephone: ______________

                                                                                         School

U.S. Institution: ______________________________  E-mail_____________________

 

Current Address: _________________________________________________________

                                  

                            _________________________________________________________

 

Home Address: __________________________________________________________

                                                                                         Home

                          _______________________________ E-mail _____________________

 

Home Telephone: ___________________________ Age: ____ Marital Status: ________

 

Special Needs: ___________________________________________________________

 

GPA at end of fall semester 2005 (must be at least 3.2): ___________________________

 

Number of academic hours completed: _____________ Years in college: ____________

 

I desire to study in Northern Ireland (full-year applicants receive priority):

 

            ______ Entire 2006-2007 school year

 

            ______ Fall 2006 semester only

 

            ______ Spring 2007 semester only

 

List your choice of institutions in order (1 = first choice, 2 = second choice, 3 = third choice):

______ BIFHE        ______ Queens University       ______ University of Ulster

 

 

Applicants must see that four copies of the following documents are submitted by the applicant’s home college or university and postmarked by February 1, 2006.

 

§         A completed nomination form from the applicants college or university

§         A copy of the applicant’s academic transcript through the fall 2005 semester

§         A 500-word essay stating the applicant’s education objectives while studying in Northern Ireland

§         Two letters of recommendation – one from the applicant’s academic advisor and one from a faculty member or administrator at the applicant’s institution
Nomination form