Social Justice and Development Internship Program

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Date: / MM / DD YYYY
Term: *
Full Legal Name: * Title First Last Suffix
Date of Birth: * / MM / DD YYYY
Gender: * Male Female
Address:
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Home Phone: * - (###) - ### ####
Other Phone: - (###) - ### ####
Email 1: *
Email 2:
Permanent Address:
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Name of Parent or Guardian (If under 21 yrs. of age): First Last
Address:
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone Number: - (###) - ### ####
Email:
Passport Number: *
Issuing Country: *
Expiration Date: * / MM / DD YYYY
I verify that my passport is valid for at least 6 months after my expected return from my ICADS' program: * Yes No
University: *
Major:
How did you hear about ICADS? (Please specify reference):
Current Class: Freshman Sophomore Junior Senior Gap Year
Contact person to be notified in case of an emergency: *
Contact Phone Number: * - (###) - ### ####
Additional Phone Number: - (###) - ### ####
I have asked the following persons to write in support of my application:
Name First Last
Name First Last
How much formal study of Spanish have you had and where? *
Rank yourself on a scale of 1 to 5, 1 being no formal study and 5 being bilingual. *
What is your motivation to learn Spanish? *
Have you ever traveled or lived in a Spanish speaking country? If so, where and for how long? *
List all courses not on your transcript which you will have completed before the beginning of the program: *
What course work and reading have you done on Latin America? *
Have you ever participated in a field work program or independent research project? If so, please specify. *
List any honors or scholastic awards.
Have you participated in extracurricular activities related to issues covered by this program? If so, please describe them. *
Describe your reasons for wishing to participate in this program, including how your career, and larger life goals are related to the experience you would expect to have at ICADS. *
Have you ever worked with or lived among people quite unlike yourself? If so, please discuss the circumstances and your adjustment to them. *
The objectives of the ICADS semester programs are much broader than language acquisition and the study of Latin American history. In this program you will be required to experience Latin American culture, religion, economics, and political realities firsthand. Is this distinction important to you? Why or why not? *
List three potential areas of interest for your internship: *
List any experience and/or preparation for your internship. *

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Social Justice and Development Internship Program

Social Justice and Development Internship Program

I have asked the following persons to write in support of my application:

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