International Summer Leadership Program Application

Summer 2019

Application for Israeli & Palestinian Students

(Please save a hard copy for your records.)

Name

First Name

Last Name

Date of Birth

YYYY

Current Age

Place of Birth

Passport Country

Passport #

Name (in English) exactly as it appears on passport

Passport Expiration Date (Passports must be valid until March 1, 2020 or later)

YYYY

Name of School

Current Grade

Gender

Optional Information

Complete any with which you identify.

Ethnicity(ies)

Religion(s)

Please Name 2 references who are not related to you.

Please list 2 references and their email address that we may contact to discuss your application. These references should be a teacher, advisor, coach, or community leader. Please do NOT list a family member or friends.

Reference 1

Reference 2

Please email letters of recommendation from the above 2 references within one week of submitting your application.

Email them to: info@artsbridgeinstitute.org

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Telephone

Country

(###)

###

####

Your Mobile

Country

(###)

###

####

Your Primary Email Address

Please provide information for your primary parent or guardian

Parent/guardian Name #1

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent Email 1

Please provide information for a second parent or guardian, if applicable

Parent/guardian Name #2

Address 2

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent Email 2

Additional Information

What languages do you speak?

What is your t-shirt size?

Essay Questions

Please answer all questions and write your answers in English. We realize that English might not be your native language so you will not be judged on the quality of your writing skills. However, we would like to get to know you better. Please use your imagination!

1. Write a short autobiography. (up to 2 pages, typed and double spaced)

2. Let us know what is important to you and tell us about what you value.

3. Why do you want to participate in Artsbridge and how do you expect to benefit from your experience.

4. Describe a conflict that you have experienced and how it has affected you.

5. What are your artistic skills and creative interests? (examples: drawing, music, dance, sculpture, painting, carpentry, writing, poetry, etc.) You do not need to have prior experience with art to participate in the summer program.

6. How would your friends describe you?

7. How would your teachers describe you?

8. What else would you like us to know about you?

Please review your answers carefully. Once you click the submit button you will not be able to go back and make changes. It is also highly recommended that you save a copy of your answers.

Scholarship Information

Tuition for the summer program is $2,000. This is a small portion of the actual cost of the program per student. However, we do not want any accepted student to be turned away for financial reasons. Therefore, we do offer scholarships to students who need it. We cannot guarantee that you will receive the full amount of your request. If your family will need a scholarship in order for you to participate, please check the box below and we will send you an application form.

Will you be applying for a scholarship?

Yes, please send me a scholarship application.

No, my family will be able to pay the full tuition.