High School Summer Institutes Application

Complete all fields on the attached Program Application, print, and sign. Make sure that the email address you submit in the Student Email field is valid and is the email address you check on a regular basis. We communicate with all applicants via email. In addition to your Program Application, you must also submit the following:

Personal Statement, see #5 on application Teacher Recommendation, in sealed envelope Official High School Transcript, including standardized test scores, in sealed envelope Application for Scholarship Assistance and copy of 2012 federal income tax return (if applying for assistance) Application Fee, if mailed after February 15 ($35 for U.S. citizens, $70 for international students)

All application materials must be mailed together in one envelope and received by the application deadline. Be sure to keep a copy of your application materials for your records. Please make all checks payable to Washington University. Send your complete application packet to: High School Summer Experiences Washington University in St. Louis Campus Box 1145, January Hall 100 1 Brookings Drive St. Louis, MO 63130-4899 Do you have questions about applying? Contact us at [email protected] or 866-209-0691.

2013 Application High School Summer Institutes

type or print clearly
Enclose application fee if mailed after February 15: $35 for U.S. citizens, $70 for international students, payable to Washington University

Applying to:
Pre-Medical Institute June 9-June 29 Pre-Medical Institute July 28-August 16 Pre-Engineering Institute June 30-July 13 Global Leadership Institute July 14-July 27 Writing Institute June 30-July 13

1.

Student Information Name: ____________________________________________________________________________

last first middle prefer to be called

Male

Female

Permanent mailing address: ______________________________________________________________________________

number and street

_____________________________________________________________________________________________________
city state zip country (if not US)

Home phone: ( Student cell phone: (

) __________________________________ ) _______________________________

Date of birth: _____________________________

month date year

Country of citizenship: _____________________ Is English your native language? Yes No

Student email address: ______________________________________ 2. Parent Information:

Mother: ___________________________________________ Father: ___________________________________________

last first last first

__________________________________________________ _________________________________________________
address (if different from above) address (if different from above)

)_________________ (

) _________________

)_________________ (

) _________________
work phone

home phone

work phone

home phone

__________________________________________________
email address

________________________________________________
email address

Parents are: 3.

married

divorced

separated

If divorced or separated, custodial parent:

Mother

Father

High school: ___________________________________________

name

__________________________________________
city state

High School Graduation:__________________________________

month year

Public Telephone: (

Private

Boarding

Counselors name:_______________________________________ 4. How did you first learn about High School Summer Institutes? high school counselor or teacher received brochure in the mail

)__________________________

Washington University website or admissions officer Google search other: ______________________________ (over, please)

Part 2 of 2013 Application High School Summer Institutes

type or print clearly 4. Courses you are taking during the spring semester of 2013: ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ 5. 6. Personal Statement: Please type a one-page statement addressing how your chosen institute will benefit you as a student. Recommendation: Have an academic teacher write, and return to you in a sealed, signed envelope, a recommendation on your behalf using the attached form. Your teacher recommendation should be completed by a teacher who can speak to your abilities pertaining to the institute you are applying to: Writing Institute: English Pre-Medical Institute: Science or Math Pre-Engineering Institute: Science or Math Global Leadership Institute: Business or Social Science 7. Transcript: Request that your counselor provide you with an official copy of your latest complete high school transcript in a sealed envelope with your counselors signature across the seal. Be sure to request that your standardized test scores (SAT, PSAT, ACT, or PLAN) be included. Application for Scholarship Assistance: If you are applying for scholarship assistance, the Application for Scholarship Assistance, must accompany your program application. We must have a copy of your parents 2012 federal income tax return before we can consider your application for assistance. International applicants must provide official documentation in English of parents income in 2012, in U.S. dollars. Enclose your completed application, personal statement, recommendation form, transcript with test scores, application for financial assistance (if applicable), and application fee IN A SINGLE ENVELOPE and mail to the address below. Be sure to keep a copy for your records before mailing. High School Summer Experiences Washington University Campus Box 1145, January Hall 100 One Brookings Drive St. Louis, MO 63130-4899 10. Signature: I certify that the information contained herein is true, complete, and correct. I understand that all materials pertaining to my acceptance become the property of Washington University. Signature of applicant:__________________________________________________ Date:___________________

8.

9.

Teacher Recommendation High School Summer Experiences

To the student: Please complete this section only, and give this form to your teacher. Make sure he or she returns this form to you in a sealed envelope with their signature across the flap. Students Name: _________________________________________________________________________________________
last first middle

High School: ____________________________________________________________________________________________

official name

High School Address: _____________________________________________________________________________________

address city & state zip

To the teacher: Please complete and sign this form. Return it to the student in a sealed envelope with your signature across the flap. Your candid estimate of the students academic performance, intellectual promise, and personal qualities will greatly help the Acceptance Committee.

Course in which you have taught this student: _________________________________________________________________ Is this course: honors? AP? IB?

Evaluate the student in terms of the following characteristics by making a check under the appropriate heading. Please compare this student with his or her entire class.

Outstanding (top 5%) Academic motivation Intellectual ability Interaction with peers Emotional maturity Respect accorded by faculty Perseverance

Excellent (next 10%)

Above Average

Average

Below Average

(over, please)

Teacher Recommendation, Part 2

How would you rate the strength of the students academic performance and achievement in comparison to other students in the course?

Are there any special circumstance, background information, or other factors (positive/negative) that affected his or her performance in high school, or are likely to do so in a precollege summer program?

If accepted, this student would be part of a college environment and taking college courses alongside other college students. Please comment on his/her maturity and ability to be successful in a college environment.

If this student is a non-native speaker of English, on a separate sheet of paper please give your candid assessment of his/her ability to speak, read, write and understand English. It is in the students best interest that you provide us an accurate a ppraisal of his/her ability to do college-level work in English.

Signature ____________________________________________________________________ Print Name _______________________________________________ High School telephone number ( ) ___________________

Date __________________

Position ____________________________________

Teacher Email _____________________________________

Confidentiality and privacy rights: Federal law guarantees only enrolled students the right of access to their educational records. Applicants have this right only after actual registration, not during the acceptance process. Your recommendation will be used for selection purposes to Summer Experiences programs only and will not become part of his or her educational record. Washington University, therefore, can guarantee the strict confidentiality of this recommendation.

2013 International Applicant Supplement High School Summer Experiences

type or print clearly This form must be completed by all international applicants. An international applicant is anyone without a U.S. passport and/or who live outside the United States.

Name: ________________________________________________________________________________________________
last first middle prefer to be called

Student Email: ________________________________________________________________________________________________________________ (This should be the personal email address that you check regularly)

English Proficiency Washington University requires that students applying for this program have a minimum TOEFL score of 90 or a minimum IELTS score of 7. Please select which test you have taken, and include an official copy of your score report with this form. TOEFL IELTS Score: ____________ Score: ____________ Date of Exam: _____________ Date of Exam: _____________

I have not taken either of these exams.* *If you do not have one of these scores, we will need other supporting documentation for English Proficiency. You should obtain an additional letter of recommendation from an English teacher specifically addressing your English skills, both written and verbal. We may also require an interview via Skype to determine acceptance. One-Page Essay Please type a one-page essay addressing what you believe will be your greatest challenge as an international student learning in an American college classroom.

Additional Guidelines for International Applicants: The $70 application fee must be paid either by an international cashiers check or money order drawn on a major U.S. bank in U.S. funds payable to Washington University. If you are applying for financial aid, we need official documentation, in English, of your parents' total income for 2012. Everything must be represented in U.S. dollars and must be translated into English. If you are unable to take the SAT or ACT tests, you should submit an additional letter of recommendation from an academic teacher to help compensate for this. If you are accepted into the program, you may need an F-1 student visa. We strongly recommend that you submit your program application as soon as possible to allow time for the lengthy and complex visa process.