Christianson Grant Application

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FOUNDATION

Christianson Grant Application


PERSONAL DETAILS
Last Name: Mailing Address:
STREET ADDRESS

Please type or print clearly and mail with $50 Application Fee to the InterExchange Foundation by the current deadline.

First Name:

Middle Initial:

Valid Until:
CITY STATE ZIP CODE

Home Telephone: Email: Date of Birth:


MM/DD/YYYY

Mobile Telephone: Gender: Country of Citizenship: Male Female

EDUCATION
SCHOOL NAME CITY/STATE YEAR GRADUATED MAJOR/COURSE STUDY

HIGH SCHOOL

COLLEGE/UNIVERSITY

GRADUATE/PROFESSIONAL

What languages do you speak other than English? (Please rate level) Fluent Good Fair Fluent Good Fair

PREVIOUS INTERNATIONAL TRAVEL


COUNTRY DATES REASON

PROGRAM DETAILS
Location of program (City, Country): Describe in detail your self-arranged program or project (include organization names, locations, activities, and dates):

Program Dates:
MM/DD/YYYY

to
MM/DD/YYYY

(must be at least 6 months long)

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Christianson Grant Application

How did you hear about the InterExchange Foundation Grant Program? Another Website Campus Event Friend/Family Online Search Poster Professor/Advisor Newspaper/Publication

Please explain in detail (What site did you search and what keywords did you use? What is the name of your advisor? What newspaper did you see an ad in?, etc.)

BUDGET
Outline how you intend to use the grant (You MUST provide proof of ALL program, ight, and legal documentation expenses. Please attach receipts and a copy of the program fees from your organization):
EXPENSE AMOUNT (US DOLLARS) EXPENSE AMOUNT (US DOLLARS)

Program Fees Airfare Local Transportation Passport & Visa Fees

$ $ $ $

Housing & Meals Travel Insurance

$ $

Total

0.00

Explain why you are seeking nancial assistance and whether you will receive other funding to participate in your program:

ESSAYS
Personal Essay: Please provide an essay (1-2 pages) that answers the following question: How will your international work opportunity contribute to better cross-cultural understanding? Supplemental Essay: Please choose one of the following questions & provide a short essay (2-3 paragraphs): 1. What do you feel you can contribute toward the mission of your chosen organization? 2. What do you hope to learn from your chosen work abroad experience?

APPLICATION CHECKLIST
Your application must consist of the following items: Completed and signed Application Form Personal Essay Supplemental Essay Resume Two Letters of Recommendation - Signed and Sealed Photocopy of U.S. Passport or Permanent Resident Card $50 Non-Refundable Application Fee Deadlines: March 15, July 15, October 15 Mail complete applications to: ATTN: Grant Selection Committee InterExchange Foundation InterExchange, Inc. 161 Sixth Avenue, 10th Fl. New York, NY 10013

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Christianson Grant Application

AGREEMENT
I, the undersigned, certify and agree that: I have read the relevant InterExchange Foundation pages on the InterExchange website thoroughly and I am eligible to apply for an InterExchange Grant; All the information I have provided in this application is truthful and accurate; If awarded an InterExchange Grant, I will submit a written report upon completion of my program describing how the grant allowed me to gain international understanding through working abroad; My report and any photos/videos I submit will become the property of the InterExchange Foundation and may be used in promotional materials; If I do not complete my program abroad, I will return the grant in full to the InterExchange Foundation; I will not hold InterExchange, Inc. liable for my personal welfare during my program participation abroad. InterExchange, Inc. and the InterExchange Foundation assume no responsibility or obligation beyond providing the grant.

Signature of Applicant:

Date:
MM/DD/YYYY

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