SEO application form - Sponsors for Educational Opportunity

S p o n s o r s f o r E d u c a t i o n a l O p p o r t u n i t y2011 SCHOLARS PROGRAMADMISSIONS APPLICATIONDeadline 12.09. 2011SECTION 1: Applicant Information (please print clearly)1. School Name 2. Current Grade3. Student NameFirstLast4. Graduation Year5. Address Apt. #Borough Neighborhood State Zip code6. Home Telephone7. Parent’s Cell Phone Applicant's Cell Phone8. Email 9. Gender M F 10. Age11. Birth Date ______ /_______ /_______ / 12. Applicant’s Social Security #13. US Citizen Permanent Resident Other14. Ethnicity (please check all that apply):African AmericanAfrican Black (including Africa and Caribbean)Caucasian / Non-Hispanic WhiteEast AsianSoutheast AsianHispanic, Latino(a)Other15. Who else lives at home with you?Name Relationship Age1.2.3.4.5.16. Language predominately spoken at home:English Spanish Creole Cantonese Other17. Do you have a brother/sister who completed college or is attending college? Yes No18. Do you have a brother/sister who completed SEO or is attending SEO? Yes No19. Do you attend any other programs during the week? Yes No If yes, please listWhat day(s) of the week do you attend other programs? M Tu W Th F S Su20. How did you hear about SEO? Teacher Info session Counselor Parent OtherApply online at www.seo-usa.org/ScholarsAdmissionsPages of Application:1. Introduction2. Checklist3. Applicant Information4. Custodial Parent/GuardianInformation,Non-Custodial Information5. Custodial Parent/GuardianResponse6. Applicant Short Response,Applicant Essay,Signatures7. Teacher Recommendation3/7

S p o n s o r s f o r E d u c a t i o n a l O p p o r t u n i t y2011 SCHOLARS PROGRAMADMISSIONS APPLICATIONDeadline 12.09. 2011SECTION 2: Custodial Parent / Guardian Information (Please print clearly.)21. Parent / Guardian name 22. Relationship to Student23. Address (If different from that of student) Apt. #Borough Neighborhood State Zip code24. Home Telephone Work TelephoneCell Phone25. Parent / Guardian Email26. Highest educational level achieved by parent / guardian living in the household:Mother / GuardianGEDSome high schoolHigh school graduateSome collegeAA degreeFather / GuardianGEDSome high schoolHigh school graduateSome collegeAA degree27. Occupation of head(s) of household:Mother / GuardianOccupationBA / BS MBA MA / MS Ph.D., JDdegree from an American college or universitydegree from a college or university outside the USFather / Guardian28. Total household income (yearly)*OccupationEmployer*All applications must include income verification; for example, a recent federal tax return.Non-Custodial Parent (Please print clearly.)29. Mother’s Name 30. Father’s NameAddressHome TelephoneWork TelephoneEmailBA / BS MBA MA / MS Ph.D., JDdegree from an American college or universitydegree from a college or university outside the USAddressHome TelephoneWork TelephoneEmailApply online at www.seo-usa.org/ScholarsAdmissionsEmployerPages of Application:1. Introduction2. Checklist3. Applicant Information4. Custodial Parent/GuardianInformation,Non-Custodial Parent5. Custodial Parent/GuardianResponse6. Applicant Short Response,Applicant Essay,Signatures7. Teacher Recommendation4/7

S p o n s o r s f o r E d u c a t i o n a l O p p o r t u n i t y2011 SCHOLARS PROGRAMADMISSIONS APPLICATIONDeadline 12.09. 2011SECTION 3: Custodial Parent / Guardian Response Section (Please print clearly.)Pages of Application:1. Introduction2. Checklist3. Applicant Information4. Custodial Parent/GuardianInformation,Non-Custodial Information5. Custodial Parent/GuardianResponse6. Applicant Short Response,Applicant Essay,Signatures7. Teacher RecommendationSEO provides academic programming 3-4 Saturdays (8:30am - 4:30pm) a month and up to 2 afternoons(4:30pm-6:00pm) a week during the school year. Scholars also attend full-day academic programmingfor 3 to 4 weeks during the summer.1. Why do you want your child to be a participant in the SEO program?¿Cuál es la razón por la que usted desea que su hijo participe en el programa de SEO?Apply online at www.seo-usa.org/ScholarsAdmissions5/7

S p o n s o r s f o r E d u c a t i o n a l O p p o r t u n i t y2011 SCHOLARS PROGRAMADMISSIONS APPLICATIONDeadline 12.09. 2011SECTION 4: Applicant Short Response SectionSECTION 5: Applicant EssayPages of Application:1. Introduction2. Checklist3. Applicant Information4. Custodial Parent/GuardianInformation,Non-Custodial Information5. Custodial Parent/GuardianResponse6. Applicant Short Response,Applicant Essay,Signatures7. Teacher RecommendationDIRECTIONS: Please type short responses (a half page per question) for each of the questions listedbelow and attach the responses to your application. Your responses will be assessed in terms of theirorganization, development of ideas, and grammar.1. Discuss some issue of personal, local, national, or international concern and its importance to you.2. Why do you want to be a part of SEO and how do you think the program can help you?DIRECTIONS: Please write an essay (250 words minimum) on the topic listed below and attach it toyour application. This personal essay will help us become acquainted with you as a person and student,apart from courses and grades. It will also demonstrate your ability to organize your thoughts andexpress yourself. Your essay will be assessed in terms of its organization, development of ideas, andgrammar.1. In a five-paragraph essay, select three words that describe you best and tell us how you will use thesequalities/characteristics to contribute fully to your learning environment in school and at SEO.SECTION 6: Parent / Guardian and Student Acknowledgement and SignaturesI acknowledge that I have reviewed the application for my student and confirm that all information iscorrect. I understand SEO is a highly competitive program and that applying does not ensure acceptanceto the Scholars Program. Should my student receive an offer of admission to the Scholars Program,he or she will be required to notify SEO of his or her intention to participate within 48 hours of acceptance.Failure to do so, may forfeit any rights of Program participation. I also affirm that should my child beaccepted and choose to participate, I will attend Program Orientation.I authorize all schools attended to release all requested records and authorize review of my child’sapplication for admission to the SEO Scholars Program.Custodial Parent / Guardian SignatureI certify that all information submitted in the admission process – including the application, the personalessay, any supplements, and any other supporting materials – is my own work, factually true, andhonestly presented.Applicant SignatureApply online at www.seo-usa.org/ScholarsAdmissionsDateDate6/7

S p o n s o r s f o r E d u c a t i o n a l O p p o r t u n i t y2011 SCHOLARS PROGRAMADMISSIONS APPLICATIONDeadline 12.09. 2011SECTION 7: Teacher Recommendation Form (Please print clearly.)Student’s NameTeacher’s NameSchoolClassPages of Application:1. Introduction2. Checklist3. Applicant Information4. Custodial Parent/GuardianInformation,Non-Custodial Information,5. Custodial Parent/GuardianResponse6. Applicant Short Response,Applicant Essay,Signatures7. Teacher RecommendationDear Teacher,The above student has applied to Sponsors for Educational Opportunity (SEO) Scholars Program which providesmotivated students with academic enrichment classes, mentoring, college planning and a variety of other specialopportunities. Thank you for your evaluation of the applicant. Your evaluation will assist us in determining thestudent’s academic and personal ability to participate in a rigorous out-of-school program.How long have you known the applicant?Rate the student on a scale of 1-5 in the areas below:Low Average HighStudent’s academic performance in your classStudent’s overall level of effort put into your assignmentsStudent’s attitude toward learningStudent’s openness to feedback and new experiencesStudent’s ability to follow through on commitmentsStudent’s ability to work in a group and teach othersStudent’s behavior in classStudent’s achievement in relation to potentialStudent’s vision for self in the future111111111222222222333333333444444444555555555SHORT RESPONSE Is there any personal quality or skill that sets this student apart from other studentsin your class?Teacher’s SignatureDatePlease return this form in a sealed envelope to the student or mail directly to:Attn: AdmissionsSEO Scholars Program55 Exchange Place, Suite 601New York, New York 10005Apply online at www.seo-usa.org/ScholarsAdmissions7/7