The World Affairs Forum – Study Abroad Scholarship Program Application Form

  The Norman Woodbury Scholarship (for College and University students)  

 

Name:_______________________________________________________________

           First                                Middle                                  Last

Social Security Number: ________________________________________________

Address: ____________________________________________________________

City: _______________ State:__________________ Zip: _____________________

Home Phone: _________ Other Phone: ___________ Email: __________________

College/University you now attend (name and address):

___________________________________________________________________

Expected Date of Graduation (mo/yr): ____________________________________

Date of Birth: _______________________________________________________

U.S. Citizen:  Yes _____ No (please indicate current status) ___________________

Father's (or Guardian's) Name: __________________________________________

Father's (or Guardian's) Home Address: ___________________________________

Home Phone: __________________ Work Phone: __________________________

Name and Address of Father's (or Guardian's) Employer:

__________________________________________________________________

Father's (or Guardian's) Title/Position: ____________________________________

Mother's (or Guardian's) Name: _________________________________________

Mother's (or Guardian's) Home Address: __________________________________

Home Phone: ____________________  Work Phone: _______________________

Name and Address of Mother's (or Guardian's) Employer:

__________________________________________________________________

Mother's (or Guardian's) Title/Position: ____________________________________

 

1^st Choice Program  

Name of Institution/Program: _____________________________________________

Location (City/Country): _________________________________________________

Time Period:  From (mo/yr): ________________ To (mo/yr): __________________

Have you applied?     Yes ____No ____  

Have you been accepted?    Yes ____ No/Pending ____

Why did you choose this program?

_____________________________________________________________________

_____________________________________________________________________

2^nd Choice Program (if applicable)

Name of Institution/Program: ______________________________________________

Location (City/Country): __________________________________________________

Time Period:  From (mo/yr): _________________  To (mo/yr):__________________

Have you applied?   Yes ____ No ____

Have you been accepted ?   Yes ____ No/Pending ____

Why did you choose this program?     

______________________________________________________________________

______________________________________________________________________

School and Community Activities and Awards (add page if desired): 

Activity                                                                       Number of Years
(Incl. Offices Held and/or Awards)

_______________________________________       _______________________

_______________________________________       _______________________

_______________________________________       _______________________

Employment (optional) 

 Employer                     Position                                     Dates

_________________________________________          ___________________________

Please provide a 500 word essay on one of the following topics:

• How does your desired study abroad program fit into your educational or career goals?
• How will study abroad be of benefit to you and to the community in which you live?

Include with your application form the following:

• College Transcript (through Fall semester of 2007)
• Minimum of 2 recommendations - 2 professors or 1 professor/1 advisor required
• Copy of your FAFSA Student Aid Report or CSS/Financial Aid Profile
• If you are receiving financial aid from your home institution, provide a copy of your award letter
• An official statement from your school's financial aid office or study abroad office that outlines your school's policies regarding transferability of your financial aid to the program that you propose to do abroad
• Copy of first two pages of parent's most recent federal income tax return
• (Optional) Letter describing any extenuating circumstances.

Student and Parent Statement:
We understand that this is only a scholarship application and that the World Affairs Forum does not make any representations or assurances regarding the availability of scholarships. 

We represent that this application reflects the work of the scholarship candidate.

We understand that any false statement, alteration or omission of pertinent information from this application will be considered just cause for removal of application from consideration.

Date:_____________________

Student (signature required):             Parent or Guardian (signature required):
_______________________________            _____________________________

Kindly return your completed application postmarked no later than March 31, 2009, to:

World Affairs Forum Scholarship Program
800 Summer Street, Suite 340
Stamford, CT 06901