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National Security Language Initiative for Youth, 2015-16 Application Sample
About the Application - Table of Contents and Deadlines
Application Deadline Thursday, 30 Oct 2014, 4:00 PM U.S. Eastern Time
Sections of the Application
A. AbouttheApplication
A. TableofContentsandDeadlines
B. HowtoApply
B. PersonalInformation
A. BiographicalInformation
B. CertifyYourEligibility
C. InternationalExperience
D. Activities,Awards,andInterests
E. Photos(Upload)
F. StatisticalInformation
C. RecommendationRequestforTeacherandParent/LegalGuardian A. TeacherRecommendation
B. Parent/LegalGuardianStatement
D. Placement Information
A. ProgramPreferences
B. Placement Information C. MedicalInformation
E. Host Family Letter and Short Essays
A. Self-IntroductiontoHostFamilyandLanguageInstructors
B. Essays
F. LanguageExperience
A. KnowledgeofLanguages
B. Self-AssessmentofNSLI-YLanguages
G. DocumentstobeMailedtoAmericanCouncils
H. ReviewandSubmit
Application Deadline and Submission of Required Documents
Deadline
What's Due for Applicants?
What's Due for Others?
Due Online Thursday, 30 Oct 2014, 4:00 PM U.S. Eastern Time
All sections of the online application completed by the applicant
(Nothing due for Others)
Due Online Wednesday, 19 Nov 2014, 4:00 PM
(Not hing due for Applicant )
All sections of the online parent/legal guardian statement completed by the parent/legal guardian and the online teacher recommendation completed by the recommender.
U.S. Eastern Time
Postmarked No Later Than Wednesday, 19 Nov 2014
Mail-In Documents
Terms and Conditions Form (Signed by applicant and all parents/legal guardians)
Send signed Terms and Conditions and Grade Transcript documents to:
ATTN: NSLI-Y File Processing (#1100)
American Councils for International Education 1828LSt NWSte1200
Washington DC 20036-5136
Mail-In Documents
Grade Transcript sent by School Registrar or Home School Supervisor
About the Application - How to Apply
Application Deadline Thursday, 30 Oct 2014, 4:00 PM U.S. Eastern Time
How to Apply
Each applicant must:
Complete and submit the application form online. All applications and recommendation forms must be submitted online, except in rare cases in which the applicant can demonstrate that this requirement presents a significant impediment to applying for a NSLI-Y scholarship. Applicants who need to make alternativ e arrangements for submission of their application must do so by October 10, 2014. Applicants who need further assistance may contact American Councils at 866.790.2086, or nsliy@americancouncils.org.
Mail to NSLI-Y the completed signature page of the Terms and Conditions Form, which must be signed by the applicant and all parents or legal guardians.
Request an official copy of his/her grade transcript be sent by mail to NSLI-Y from his/her high school. Transcripts must include completed courses, grades, and GPA.
Hav e one (1) teacher submit a recommendation online supporting his/her application.
Hav e one (1) parent/legal guardian submit a statement online supporting his/her application.
Note: Any technical problems with the application form should be reported by email to nsliy@americancouncils.org, howev er, there is no guarantee that NSLI-Y staff can respond to inquiries on Thursday, 30 Oct 2014, 4:00 PM U.S. Eastern Time. NSLI-Y strongly encourages that applicants ask any questions and submit their applications well in advance of the application deadline. The NSLI-Y program and American Councils for International Education bear no responsibility for data transmission problems in submitting the application.
When emailing nsliy@americancouncils.org, please use the following subject line conv ention: Reference Code, Last Name, First Name: Email Subject
Ex: ABCE1234, Doe, Jane: Question about application
Note: Your reference code is the eight-digit, randomly-assigned code at the top of this page with four letters and four numbers that identifies your unique application.
How to Use this Online Form Detailed Application Instructions
Section-specific instructions can be found on the NSLI-Y website: www.nsliforyouth.org/how-to-apply.
Moving from Section to Section
This online form includes sev eral sections (pages). They are listed in the "Sections" menu that can be found in the
| nav igation menu at the left side of each page, as well as in the Table of Contents on page one. You may select any section from the menu to jump to that section. You may also press the "Next" and "Prev ious" buttons to switch to the next and prev ious sections of the form. Saving Your Work To sav e your work at any time, press the "Sav e Changes" button that can be found at the bottom of any page. It is a good idea to regularly sav e your work while completing the form to ensure that none of your work is lost in the Completing Your Application in Multiple Sessions It is not necessary to complete your online form in one sitting. To continue later, press the "Sav e Changes" button that can be found at the bottom of any page, and then log out of the system. You can then log in at any time thereafter until the application deadline of Thursday, 30 Oct 2014, 4:00 PM U.S. Eastern Time. After your application is submitted, you will not be able to make changes. Required Fields A * next to a question indicates a required field. You must prov ide this information in order to submit your form. A Note about Word and Character Counts Used in this Online Application Any minimum or maximum word or character counts specified in the instructions for some questions will be as indicated by the counter tool used in this form. Please note that this count may not be the same as counts indicated by Microsoft® Word, OpenOffice.org Writer, or other word-processing tools. Submitting Your Application After rev iewing all sections of your online form, you must press the "Submit" button on the last page. If you do not press the Submit button, your form will be considered incomplete and will not be considered for selection. You will not be allowed to make any changes after you submit it. Any technical problems with the application form should be reported by email to nsliy@americancouncils.org. NSLI- Y strongly encourages that applicants submit their applications in advance of the application deadline. The NSLI-Y program and American Councils for International Education bear no responsibility for data transmission problems in submitting the application. Downloading Documents from this Website The free Adobe Reader is required to open and v iew most documents on this Uploading Documents and Photographs to Your Form Some forms will ask you to upload a document or photograph. In most cases, you may upload only files of the following types: PDF, JPG/JPEG, PNG, GIF, or TIF/TIFF. You may also be asked not to upload files with a size greater than 2 MB. Encrypted or password-protected files will not be accepted unless "Read Only" capability is enabled. You may use the following free online tools to conv ert or resize your files: For Photographs: Webresizer www.webresizer.com/resizer/ Questions? For information about the NSLI-Y program, please v isit www.nsliforyouth.org website. |
Telephone: 866.790.2086
Personal Information - About You About You
1) Legal Name
As indicatedonyour birthcertificate, passport, or other government-issuedID
Legal First Name *
Legal Last Name *
-
2) Your Preferred Nickname
-
3) Sex* Male
Female
-
4) Date of Birth *
MMM dd, yyyy(e.g., Sep 30, 1997)
Legal Middle Name Suffix (e.g., Jr., Sr., III, et c.)
Note: Eligible students must have birthdates within the range listed below:
-
5) Place of Birth Country of Birth *
Please first t ell us t he count ry(including t he U.S.A.)
Choose
City of Birth * U.S. State or Possession of Birth Choose
If you were NOT born in the U.S.A., enter the name of your prov ince/region of birth, or write "none". *
-
6) Do you hav e a v alid U.S. passport? * Yes
No
NSLI-Y finalists will be expected to have a valid U.S. passport for at least six months after their anticipated program end date. Semi-finalists should be prepared to submit passport information by late February 2015. (Please note that if you are selected to study in Russia, your passport must be valid for 18 months after your anticipated return the U.S., and if you are selected to study in India or China, your parent(s) or legal guardian(s) may also be required to have a valid passport(s) to obtain a visa.) Note that passport processing time may be lengthy. Semi-finalists are strongly encouraged to apply for passports if they do not have one that meets validity requirements at the time of semi-finalist
| Duration | Eligible Birthdate Range |
| Summer | Birthdate: July 15, 1996 – June 10, 2000 |
| Academic Year | Birthdate: September 30, 1996 – June 30, 2000 |
| notification. 7) Can you be considered a citizen of any country other than the U.S.A.? * Yes No Your Contact Information
10) Telephone Numbers: Primary Telephone * 11) Primary Email Address * Thiscanbeapersonalor familyemailaddress;it shouldbeanemailaddressthat willbecheckedoftenbytheapplicant or im m ediat e fam ily m em ber . Type * Choose Type Choose |
12) Alternate Email Address
13) Tell us your U.S. Congressional District if you liv e in:
The United States, American Samoa,
Guam,
Northern Mariana Islands, Puerto Rico, or
The U.S. Virgin Islands,
Find your district: http://www.house.gov /representativ es/find.
U.S. State or Possession
Choose
District Number
Choose
Personal Information - School Information Your High School Information
-
1) Your Current Grade * 9th
10th
11th
12th
-
2) Your Anticipated Graduation Date *
Enter informat "MMMyyyy"Example:"Jun2016".TheacceptabledaterangeisDec2014throughJul2018.
If you are home-schooled, please enter the following:
For the School Name field, enter "Home School"
For the school address and telephone fields, enter your home address and telephone For Web Site field, enter the web site address of your local school district or "None"
-
3) School Name *
-
4) School Address
Country *
Please first t ell us t he count ry(including t he U.S.A.)Choose
Street Address or PO Box *
City *
U.S. State/Possession
Choose
If your school address is NOT within the U.S. postal system, enter the name of its prov ince/gov ernorate/region, or write "none". The U.S. postal system includes possessions, military, and diplomatic addresses. *
ZIP/Postal Code *
-
5) School Telephone *
-
6) School Web Site
Personal Information - Family Information About Your Parents / Legal Guardians
1) Please list each of your parents and legal guardians, as applicable:
Anyonelistedasaparent or legalguardianinyour applicationmust beidentifiedbythesame nameinother formsthat requirethe signat ur e of par ent s / legal guar dians.
Legal First Name *
Legal Last Name *
Sex * Male
Female Parent Type *
Choose
Does this person hav e legal custody of you? * Yes
No
Country of Birth * Choose
Do you currently liv e with this parent/legal guardian at the physical address you input in the prev ious
section? *
Iftheaddressofyour parent/legalguardianisdifferent thanyour physicaladdress,pleaseenter theaddressbelow.Otherwise,
| youdonot needtoinput theaddress. Yes No 0 char act er s count ed. Maxim um of 100 char act er s allowed. Country Please first t ell us t he count ry(including t he U.S.A.) Choose Street Address City U.S. State/Possession Choose If your parent/legal guardian’s mailing address is NOT within the U.S. postal system, enter the name of your Prov ince/Gov ernorate/Region of Birth, if any. The U.S. postal system includes Possessions, military, and diplomatic addresses. ZIP/Postal Code Primary Telephone * Alternate Telephone Other Telephone Email Address * Per sonal, wor k, or fam ily em ail addr ess Add1More About Your Siblings Type * Choose Type Choose Type Choose 2) Do you hav e any siblings or other household members who are also applying for NSLI-Y this year? Each applicant is evaluat ed independent ly. Yes No |
If yes, please list each of your siblings: Legal First Name
Legal Last Name Sex
Male
Female
Liv e with you?
Yes
No
Add1More
Alternate Emergency Contact
3) In the ev ent your parents or legal guardians cannot be contacted, please prov ide at least one (1) adult who does not live with you as your alternate emergency contact person. To ensure that NSLI-Y staff can contact this indiv idual promptly in case of an emergency, a phone number and email address must be prov ided for this indiv idual. Please only identify an indiv idual for which this information can be prov ided:
Legal First Name *
Legal Last Name *
Sex * Male
Female Relationship to You *
Choose
Primary Telephone *
Alternate Telephone
Other Telephone
Type * Choose
Type
Choose
Type
Choose
Email Address *
Thiscanbeapersonal,work,or familyemailaddress
Add1More
| Personal Information - Certify Your Eligibility Certification of Eligibility Eligibility requirements of the National Security Language Initiativ e for Youth (NSLI-Y) scholarship for program year 2014-2015.
|
Personal Information - International Experience
1) Hav e you prev iously participated in an NSLI-Y Program? * Yes
No
If YES, complete questions a) through d). If NO, skip to question 2.
a) When did you participate? Choose
-
b) What language did you study?
Choose
-
c) Which organization managed your program?
Choose
-
d) PleaseexplainwhyyoufeelanotherNSLI-Yexperienceisimportantorbeneficialforyou.Pleasealso describe any efforts you hav e made to continue studying the language of your last NSLI-Y experience.
0 wor ds count ed. Maxim um of 250 wor ds allowed.
2) Hav e you prev iously participated in any other international exchange program(s)? * Yes
No
a) IfYES,wastheprogramsponsoredbytheBureauofEducationalandCulturalAffairs,DepartmentofState?(See www.exchanges.state.gov /us)
Yes
No
If YES, please prov ide details on programs sponsored by the Bureau of Educational and Cultural Affairs, Department of State:
Add1More
b) IfYES,wastheprogramsponsoredbyanorganizationOTHERTHANtheBureauofEducationalandCultural Affairs, Department of State?
Yes
No
If YES, please prov ide details on all other programs:
#
Program
If other, which?
Start E Date
nd Date L
ocation
1
Choose
#
Program Name
Start Date
End Date
Host City, Country
Describe the Program
1
Add1More
3) Hav e you otherwise trav eled or liv ed abroad? * Yes
No
If YES, please explain:
0 wor ds count ed. Maxim um of 250 wor ds allowed.
4) Do you hav e any relativ es or close friends that liv e abroad? * Yes
No
If YES, please explain:
0 wor ds count ed. Maxim um of 200 wor ds allowed.
Choose
Personal Information - Activities, Awards, and Interests Activities, Athletics, and Organizations
1) List only those activ ities and organizations in which you hav e been a frequent participant within the past three years. Include activ ities such as Scouts, v olunteer work, religious youth groups, peer tutoring, sports teams, etc. Be sure to briefly specify any offices you held with those groups, such as club president, team captain, or other position.
#
1
Activity or Organization
Description (Maximum of 50 words per entry)
Hours per Month
Start Date (mm/yyyy)
Still Participating?
If NO, End Date (mm/yyyy)
Choose
Add 1 More Add 2 More Add 3 More
Paid Work or Jobs
2) Please specify the type of work and describe your responsibilities:
Add 1 More Add 2 More Add 3 More
Creative Work, Hobbies, and Special Training
3) Include activ ities such as music, dance, drama, performing arts, and foreign languages that you hav e pursued to the point of some mastery:
Add 1 More Add 2 More Add 3 More
Awards, Honors, and Special Recognition
4) Please briefly describe the award:
Add 1 More Add 2 More Add 3 More
#
Employment Title/Position
Description (Maximum of 50 words per entry)
Hours per Month
Start Date (mm/yyyy)
Still Employed?
If NO, End Date (mm/yyyy)
1
Choose
#
1
N ame
Description (Maximum of 50 words per entry)
Hours per Month
Start Date (mm/yyyy)
Still Participating?
If NO, End Date (mm/yyyy)
Choose
#
Description
Award Date (mm/yyyy)
1
Personal Information - Photos (Upload)
Photos are optional and not considered in the selection process. You may submit your application without uploading passport or other photos.
Upload One Passport-Type Photo
Upload a passport-size photo of yourself.
The photo size should be approximately 2" x 2" (5 cm by 5 cm), and show only your face from the shoulders up.
It isn't necessary to purchase an "official" passport photo for this purpose; you may approximate one with your own camera or use a yearbook-style photo. Please av oid uploading “selfies” taken with a mobile phone camera.
1) Upload Passport Photo
Youwillbetakenbrieflytoanother screenwhileyour fileisvalidatedbythissystem.
Select File...
File t ypes allowed: PDF, JPG/JPEG, PNG, GIF, TIF/TIFF
Upload No More than Two Personal Photos
To help introduce yourself to a host family or teachers, please select up to two photographs showing you by yourself, or with your family and/or friends. Be creativ e, but please ensure the appropriateness of the photographs and captions!
You may attach up to two (2) photographs.
Please re-size your photos so that [a] neither the width nor the height is greater than 400 pixels, and [b] the resolution is no greater than 100 pixels per inch.
You can use the free online Webresizer (www.webresizer.com/resizer/) to crop and re-size your photos before uploading (The "Image Quality" field in Webresizer is the resolution.)
Be sure to include a brief caption, no more than 100 characters (including spaces), with each photo, and to identify yourself in the photos.
This may be the first impression your host family or program administrators will have of you; keep it clean! Any photo and/or caption deemed inappropriate by NSLI-Y, in its sole discretion, may be removed. These photos are not considered in the selection process.
2) Photos
Youwillbetakenbrieflytoanother screenwhileyour fileisvalidatedbythissystem.
Add1More
Sample Photo and Caption:
Cooking out at a community ev ent celebrating the Fourth of July with my friends. I'm second from the left with the spatula.
| # | Upload Photo | Caption for Photo | |
| 1 | Select File... |
Personal Information - Statistical Information
| Providing this information is voluntary The information requested here will be used for statistical analysis of NSLI-Y. It will hav e no bearing on the
|
Teacher or Counselor
TV
Web Site or Internet Search
Other
If OTHER, please prov ide further detail:
0 wor ds count ed. Maxim um of 100 wor ds allowed.
5) Make intercultural learning a family experience! Perhaps your family would consider hosting an international exchange student. Would your family like to receiv e information about this unique opportunity?
Yes
No
Recommendation Requests - Teacher Recommendation
Deadline for Teacher to Submit Recommendation: November 19, 2014, 4:00 P.M. U.S. Eastern Time
Your application must include a recommendation from one of your teachers. It must be submitted using this website (AIS Forms).
It is your responsibility to ensure that the letter of recommendation is receiv ed by NSLI-Y.
Before You Request a Recommendation
Talk with your teacher to determine if he or she is willing and able to prov ide this recommendation for you.
Tell your teacher to expect an email from ais_accounts@americancouncils.org. Suggest that your teacher add this address to his or her “safe” or “contacts” list so that the message does not go into a spam or junk mail box. If he or she does not receiv e this email message, suggest that he or she check the spam or junk mail box before contacting NSLI-Y.
If your teacher giv es you a “K12” address, you may want to ask him or her to prov ide an alternativ e email address to receiv e the NSLI-Y Teacher Recommendation request. ("K12" addresses often block email messages from unknown sources, such as this application system.)
When You Are Ready to Request a Recommendation
Provide the contact information for your teacher below. NSLI-Y will use that information to send your teacher an email message that contains a link to a secure, online recommendation form.
Press "Save Changes" at the bottom of the page in order to confirm that all the information you prov ided is correct (A "Request Recommendation" button will then appear).
| Document | Instructions |
| Instructions for Your Teacher | Download this instructions document and give it to your teacher;it explains how to submit the recommendation online. |
Press the "Request Recommendation" button to send the email notification to your teacher. Prov ide Your Teacher’s Contact Information:
First Name *
Last Name *
Teacher Email Address *
Teacher Telephone
Press the "Sav e Changes" button at the bottom of the page, and then press the “Request Recommendation” button that appears to send an email request to your teacher. *
IN TESTING Confidential Teacher Recommendation Status History
After You Request a Recommendation
Confirm with your teacher that he or she receiv ed the email message and can access the form.
If your teacher does not receive the email message, first suggest he or she check the spam or junk mail box. If he or she still cannot find it, only then come back to this page and press the "Request Recommendation" button again, to send another message.
Be careful! If you change your teacher's name or email address after sending the notification message, it will cancel your prev ious request and disable his/her secure link to the online form. It will also erase any online recommendation form that was already in progress or had already been submitted. An erased recommendation form cannot be retriev ed. Be sure to consider this before changing the contact information.
Questions?
For information about the NSLI-Y program, please v isit www.nsliforyouth.org
Contact NSLI-Y staff during normal business hours, 9:00 A.M.-5:00 P.M. US Eastern Time, Monday-Friday, at: Email: nsliy@americancouncils.org
Telephone: 866.790.2086
| Date | Activity Type | Recipient Email | |
| No status found. | |||
Recommendation Requests - Parent/Legal Guardian Statement
Deadline to Submit Recommendation: November 19, 2014, 4:00 P.M. U.S. Eastern Time
Your application must include a recommendation from one of your parents/legal guardians. It must be submitted using this website (AIS Forms).
It is your responsibility to ensure that the letter of recommendation is receiv ed by NSLI-Y.
Before You Request a Recommendation
Talk with your parent/legal guardian to determine if he or she is willing and able to prov ide this recommendation for you. If your parent/legal guardian is not able to complete the recommendation in English, he or she can work with a family member or close family friend to translate the recommendation. Indiv iduals who hav e help completing their recommendation should indicate who helped them in the written portion of the form. You should not prov ide a translation for your parent/legal guardian.
Tell your parent/legal guardian to expect an email from ais_accounts@americancouncils.org. Suggest that your parent/legal guardian add this address to his or her “safe” or “contacts” list so that the message does not go into a spam or junk mail box. If he or she does not receiv e this email message, suggest that he or she check the spam or junk mail box before contacting NSLI-Y.
When You Are Ready to Request a Recommendation
Provide the contact information for your parent/legal guardian below. NSLI-Y will use that information to send your parent/legal guardian an email message that contains a link to a secure, online recommendation form.
Press "Save Changes" at the bottom of the page in order to confirm that all the information you prov ided is correct (A "Request Recommendation" button will then appear).
Press the "Request Recommendation" button to send the email notification to your parent/legal guardian. Prov ide Parent's/Legal Guardian's Contact Information
First Name *
Last Name *
Relationship to You * Choose
Parent/Legal Guardian Email Address *
Parent/Legal Guardian Telephone
Press the "Sav e Changes" button at the bottom of the page, and then press the “Request Recommendation” button that appears to send an email request to your parent/legal guardian. *
IN TESTING Parent/Legal Guardian Statement Status History
| Document | Instructions |
| Instructions for Your Parent/Legal Guardian | Dow nload this instructions document and give it to your parent/legal guardian; it ex plains how to submit the recommendation online. |
Date
Activity Type
Recipient Email
After You Request a Recommendation
Confirm with your parent/legal guardian that he or she receiv ed the email message and can access the form.
If your parent/legal guardian does not receive the email message, first suggest he or she check the spam or junk mail box. If he or she still cannot find it, only then come back to this page and press the "Request Recommendation" button again, to send another message.
Be careful! If you change your parent's/legal guardian's name or email address after sending the notification message, it will cancel your prev ious request and disable his/her link to the online form. It will also erase any online form that was already in progress or had already been submitted. An erased recommendation form cannot be retriev ed. Be sure to consider this before changing the contact information.
Questions?
For information about the NSLI-Y program, please v isit www.nsliforyouth.org
Contact NSLI-Y staff during normal business hours, 9:00 A.M.-5:00 P.M. US Eastern Time, Monday-Friday, at: Email: nsliy@americancouncils.org
Telephone: 866.790.2086
No status found.
Placement Information - Program Preferences
Please indicate your preferences for a NSLI-Y program language and duration. Language offerings are subject to change in consultation with the U.S. Department of State.
Available Programs Summer 2015
To apply for one of these programs, your date of birth must be between July 15, 1996 and June 10, 2000
Arabic - Summer
Chinese (Mandarin) - Summer Russian - Summer
Korean - Summer
Hindi - Summer
Turkish - Summer
Persian (Tajiki) - Summer
Academic Year 2015-16
To apply for one of these programs, your date of birth must be between September 30, 1996 and June 30, 2000
Arabic - Academic Year
Chinese (Mandarin) - Academic Year Russian - Academic Year
Korean - Academic Year
Hindi - Academic Year
Turkish - Academic Year
-
1) Indicate Your 1st Preference: 1st Language Preference *
Choose
1st Duration Preference * Choose
-
2) Indicate Your 2nd Preference: 2nd Language Preference
Choose
2nd Duration Preference
Choose
-
3) Indicate Your 3rd Preference: 3rd Language Preference
Choose
3rd Duration Preference
Choose
-
4) Please explain your choice of language(s) and program duration(s). Your explanation will be rev iewed as a part of your application and considered during the selection process; please focus the explanation on your first preference. Keep in mind that if you participated in a NSLI-Y summer program prev iously, you are only eligible to apply for an academic year program. No NSLI-Y applicant is eligible for a third NSLI-Y program. *
0 wor ds count ed. Maxim um of 200 wor ds allowed.
5) Hav e you or do you plan to apply to other U.S. gov ernment-sponsored exchange programs for 2015-16? * Yes
No
Placement Information - Personal Preferences
Your responses to these questions about your placement needs and preferences will not be considered during the selection process. This information will be used for school and host family placement, as appropriate. Please prov ide information on any personal needs or situations which may affect your host family.
Physical, Health, or Learning Accommodations
1) In order to help NSLI-Y plan for your program safety and participation in ev eryday family and social activ ities, please prov ide information about any physical restrictions and/or health conditions. If none, enter NONE. *
| 0 wor ds count ed. Maxim um of 150 wor ds allowed. 2) Do you hav e any disabilities (e.g. physical, sensory, learning, etc.)? * Yes No 0 wor ds count ed. Maxim um of 150 wor ds allowed. Pet/Animal Restrictions 3) What pets or other animals can you NOT liv e with? * (Check all t hat apply) Cats-Indoors Cats-Outdoors Dogs-Indoors Dogs-Outdoors Other Pets/Animals-Indoors* Other Pets/Animals-Outdoors** I hav e NO pet or animal restrictions. 0wordscounted.Maximum of50wordsallowed. * * If you checked "Other Pets/Animals-Outdoors" please list: 0wordscounted.Maximum of50wordsallowed. Dietary Restrictions 4) Do you hav e any dietary restrictions, including any restriction for medical, religious, or self-imposed reasons? * |
| Yes No 0wordscounted.Maximum of50wordsallowed. 5) If you are v egetarian, will you eat any of the following? (Skip to Question 6 if not applicable.) (Check all t hat apply) Dairy Products Eggs Fish Poultry Other 0wordscounted.Maximum of50wordsallowed. Religion
|
0wordscounted.Maximum of50wordsallowed.
10) If your host family asked you to attend its religious serv ices, would you do so ev en if your beliefs were different from theirs? *
Yes
No
Smoking
11) Do you smoke? * Yes
No
If YES, note that in some cultures, it is more difficult to find placements for smokers. Smokers should please declare their intentions, as follows:
(Choose one)
I WILL smoke while participating in NSLI-Y
I WILL NOT smoke while participating in NSLI-Y
Disclaimer
I understand that host env ironments might not be able to accommodate the restrictions or requirements that I hav e indicated in my completed application, and that acceptance to NSLI-Y is not a guarantee that these preferences can or will be honored.
I hav e read and understand the abov e disclaimer: * (Choose one)
Yes
No
Acknowledged by: * (Typeyour name)
Placement Information - Medical Information
While NSLI-Y is an inv aluable experience and a time of tremendous growth for participants, it is important for candidates and their families to understand that by its nature, NSLI-Y can also be both emotionally and physically demanding. Being immersed in a different culture, placed in an unfamiliar host family, school, and community often inv olv es emotional stress during an adaptation period that v aries from person to person.
If a candidate is currently experiencing medical, emotional, psychological, or family difficulties, or has only recently recov ered from such difficulties, the adjustment demands of a study abroad program can sev erely exacerbate such difficulties or ev en be cause for a relapse. For this reason, NSLI-Y requests as much information as possible be giv en below regarding the candidate’s health status. Your responses to these questions will not be considered during the selection process. More information on the medical rev iew process can be found in the NSLI-Y Terms and Conditions which all applicants and their parent(s)/legal guardian(s) are strongly encouraged to thoroughly
rev iew.
If selected as a semi-finalist, you will be required to have a physician complete an official NSLI-Y Medical Evaluation form and return it to NSLI-Y. This form will be made av ailable at the time of semi-finalist notification. Failure to submit this form by the stated deadline will result in rejection of your application.
NOTE: Do not submit a medical ev aluation form with your initial application; it will not be accepted.
Medical Information for Preliminary Review
|
If YES, please explain:
0 wor ds count ed. Maxim um of 100 wor ds allowed.
Certification
Please note that, should you be selected as a semi-finalist, further consideration for a scholarship is contingent upon fulfillment of the medical requirements of NSLI-Y. This includes, but is not limited to, submitting a completed health certificate on an official NSLI-Y Medical Ev aluation form by the stated deadline. This form will be prov ided to all semi-finalists. Do not submit a medical evaluation form with your initial application; it will not be accepted.
6) I certify that the information I hav e prov ided abov e is truthful to the best of my knowledge, that I hav e read the preceding statement, and that I understand that I will not be eligible for a NSLI-Y scholarship until these medical requirements hav e been fulfilled: *
Yes
No
Certified by: * (Typeyour name)
Self-Introduction to Host Family and Language Instructors
You may be hosted by a family, and just as you are curious about your host family and school, they will be curious about you. Here is a chance to tell your prospectiv e host family and school about yourself in a letter. Below are sev eral questions you need to incorporate into the body of your letter to communicate who you are and your motiv ation for going abroad with NSLI-Y. Your letter must not exceed 500 words and must be written in English. Please type your letter in the space prov ided below.
TIPS:
NSLI-Y recommends that you prepare and save the host family letter and short essays in a word processing program, such as Microsoft Word. You may copy and paste your essays into the spaces below once you hav e completed them in a word processing program.
If you choose to type your essay directly into the form below, be sure to press the “Save Changes” button at the bottom of this page every few minutes. This will ensure that your work is not lost if you encounter a technical problem.
A Note about Word Counts and Character Counts Used in this Online Application: Any minimum or maximum word or character counts specified in the instructions for some questions will be as indicated by the counter tool used in this form. Please note that this count may not be the same as counts indicated by Microsoft® Word, OpenOffice.org Writer, or other word-processing tools.
Questions that You Must Answer in Your Letter:
How would your family and friends describe your personality?
How would you describe your relationship with your family and friends? For example, how are you different from your brothers/sisters and friends? What is your role in the family? In what types of situations do you seek adv ice from your parents?
What are your different roles in your community? For example, what are your roles in school, sports, community activ ities, etc.? What is important to you?
If selected for NSLI-Y you will be part of a community and family, not a guest. Please explain what makes you unique and a good addition to a family and community.
What are your education and career goals?
Your letter will be read as part of your application and may be shared with your host family, if you are selected. Consider formatting your response like an actual letter with a salutation and closing.
Your Letter: *
0 wor ds count ed. Maxim um of 500 wor ds allowed.
Essays
Please write two (2), detailed essays about the topics listed below. Note the following: You must complete both essays.
| For the first essay, you must answer the question prov ided. For the second essay, choose one of the three offered topics. Each essay must not exceed 250 words and must be written in English. Please type your essays in the spaces prov ided below. TIPS: NSLI-Y recommends that you prepare and save the host family letter and short essays in a word processing program, such as Microsoft Word. You may copy and paste your essays into the spaces below once you hav e completed them in a word processing program. If you choose to type your essay directly into the form below, be sure to press the “Save Changes” button at the bottom of this page every few minutes. This will ensure that your work is not lost if you encounter a technical problem. A Note about Word Counts and Character Counts Used in this Online Application: Any minimum or maximum word or character counts specified in the instructions for some questions will be as indicated by the counter tool used in this form. Please note that this count may not be the same as counts indicated by Microsoft® Word, OpenOffice.org Writer, or other word-processing tools. First Essay 1) List and explain three (3) reasons why you want to participate in NSLI-Y. * 0 wor ds count ed. Maxim um of 250 wor ds allowed. Second Essay 2) Choose one of these three topics for your second essay:
I choose: * A B C |
0 wor ds count ed. Maxim um of 250 wor ds allowed.
Language Experience - Knowledge of Languages
-
1) What is your nativ e or first language? *
If you answered "English" to Question 1, then please skip to Question 2. If English is not your nativ e language, do you speak English?
Yes
No
-
2) What language(s) are spoken in your home?
-
3) Please tell us about your knowledge and proficiency with all languages that you know, EXCEPT English. Your language self-assessments will assist us with assigning you to an appropriate lev el of language class in your NSLI- Y program. Please be honest and accurate about your proficiency.
Language name:
Choose
If other, please list:
Speaking ability:
Choose
Listening ability:
Choose
Writing ability:
Choose
Reading ability:
Choose
Length of study at the time of application:
Primary setting where language was studied:
(Choose all t hat apply)
College Course
Exchange Program
High School
Junior High/Middle School
On Your Own
Primary School
Saturday School
Summer Camp
Tutor
Other
If other, please explain:
0 wor ds count ed. Maxim um of 100 wor ds allowed.
Add1More
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4) Please describe any other foreign language experience you hav e that is not cov ered abov e.
0 wor ds count ed. Maxim um of 100 wor ds allowed.
-
5) Hav e you participated in a STARTALK language program? * Yes
No
If YES, please list below the STARTALK programs you hav e attended:Add1More
#
Language
Program Location
Start Date
End Date
1
Choose
Language Experience - Self-Assessment of NSLI-Y
Language Preferences
Only complete this portion of the application if you already study or speak a NSLI-Y language and if you have chosen that/those language(s) in your program preferences. Otherwise, continue to the next page.
For NSLI-Y language(s) that you know and hav e indicated as one or more of your program preferences (Arabic,
| Chinese (Mandarin), Hindi, Korean, Persian (Tajiki), Russian, and/or Turkish), please respond to the following statements about your language study experience, as well as your ability to use and understand the language. Your responses will assist us with assigning you to an appropriate lev el of language class in your host school. Please be honest and accurate about your proficiency. Press the Add More button near the bottom of this section to list additional languages. Language Name ThisisaNSLI-YlanguageyouknowANDindicatedasaProgram Preference(Section13:Placement Information-Program Preferences). Choose If selected for NSLI-Y, would it be your first opportunity to study this language in a formal classroom setting? Yes No If you hav e studied this language in a formal classroom setting, which textbooks hav e you used in your studies? 0 wor ds count ed. Maxim um of 100 wor ds allowed. If you hav e studied this language independently, which online applications or software hav e you used in your studies? 0 wor ds count ed. Maxim um of 100 wor ds allowed. I can ask and answer simple questions about my name and place of birth, make social introductions and use greeting and leav e-taking expressions. I can describe myself in basic terms. Yes No I can read and understand the purpose and meaning of v ery short, familiar, simple written texts such as printed notes, ads, or signs. Yes No In ev eryday conv ersation with people speaking standard dialect, I can understand speech if it is slow and clear. Yes No I can giv e detailed information about my family, my house, and my community. Yes No |
Yes
No
I can listen to and understand simple communications on familiar topics, including descriptions of ev ents, feelings, wishes, and future plans.
Yes
No
I can read and understand uncomplicated stories about current, past, and future ev ents.
Yes
No
I can accurately listen to and follow all conv ersations among nativ e speakers who are speaking at a normal rate of speech.
Yes
No
I rarely find myself unable to finish a sentence because of language limitations and there are few grammatical features of the language that I try to av oid.
Yes
No
I can usually read and understand all the material in a major daily newspaper.
Yes
No
I am completely fluent and can express myself as well in the target language as in my nativ e language.
Yes
No
Add1More
Documents to Mail to American Councils
Postmark Deadline for Mailed Documents: November 19, 2014
Originals of the following documents must be mailed to American Councils at the address below, with a postmark date of no later than November 19, 2014.
ATTN: NSLI-Y File Processing (#1100)
American Councils for International Education 1828LSt NWSte1200
Washington DC 20036-5136
USA
Document
Instructions
Terms And Conditions
This agreement must be signed by you and all parents/legal guardians.
Grade Transcript Request
For applicants enrolled in an academic institution, ONLY
Submit a request to your school registrar as soon as possible. Please mail the official transcript directly to American Councils in a sealed and unopened envelope.
Home School Transcript Form
For home-schooled applicants, ONLY
You must submit the NSLI-Y Home School Transcript form.
9th Grade Transcript and Classes List Request
For 9th Graders, ONLY
Applicants w ho are currently enrolled in 9th grade must provide the follow ing tw o items:
Official School Grade Transcript from y our junior high/middle school. List of current classes enrolled in at high school.
Both these items should be mailed by the registrar directly to American Councils in a sealed and unopened envelope.
Review and Submit
Application Deadline: Thursday, 30 Oct 2014, 4:00 PM U.S. Eastern Time
Final Review of Application
Before you submit your application, please be sure to rev iew all sections. Make sure you hav e answered all the questions and required fields, and that you are satisfied with your responses. Also, be sure that you hav e downloaded any documents that must be submitted separately by mail.
Once you submit your application, you will no longer be able to make changes to any section of the application. You will be able, howev er, to continue to v iew your application online v ia this system with your existing login.
If you are not ready to submit your application, please press any "Sav e Changes" button in the application forms and log out of the system. You will be able to log in at any time, thereafter, until the application deadline, and continue to complete or edit your application.
I certify that:
Ev erything in this application is complete and true to the best of my knowledge,
Sav e Changes Discard Changes and Return to Prev ious Page Home
I understand that by submitting my application to the National Security Language Initiativ e for Youth (NSLI-Y), I am agreeing to apply for a competitiv e scholarship, and
I understand that my application is in no way an offer or a guarantee of an offer for a NSLI-Y scholarship:
Select one: * Yes
No
Certified and Agreed by: *
(Typeyour name)
Submit Your Application
If you are ready to submit your application, press the "Submit" button below. If you do not click the “Submit” button, your application materials will not be rev iewed by the selection committee.
If you have left any required questions unanswered, you will receive an error message at the top of this page after your press the "Submit Your Application" button and your application will not be accepted. You may then return to your application and enter any missing information, and then attempt to re-submit your application.
Submit Your Application
