SECONDARY SCHOOL EXCHANGE SCHOLARSHIPS
1. APPLICATION FORM
To be completed by the applicant.
Please use BLOCK CAPITALS, and return all forms and parts of your application to:
SSE – Education Department
The English-Speaking Union
Dartmouth House
37 Charles Street
London W1J 5ED
OR
[email protected]
PERSONAL INFORMATION
I am applying for the 3-term / 2-term SSE scholarship (please underline as applicable)
First Name:
Surname:
Date of birth:
Gender:
Country of Birth:
Nationality (as on your passport):
Current / most recent school (and address):
Home address:
Home telephone number:
Mobile:
Personal email:
Living with: both parents / one parent / guardian (please underline as applicable)
Name of parent(s)/guardian:
Email of parent(s)/guardian(required):
Daytime telephone number of parent/guardian:
School telephone number:
SCHOLARSHIP PREFERENCES
If your application is successful the information on this sheet will be passed to the committee of head
teachers in the US. Your preferences will be taken into consideration but it may not be possible to meet all
criteria.
Type of school you would like to attend (please underline as applicable):
boarding
day *
*If you attend a day school, the school will arrange accommodation with one or more
host families.
single sex
co-ed (mixed)
no preference
urban
suburban
rural
no preference
Please indicate the academic subjects you are interested in pursuing in the USA and why. (Scholars are
required to fully participate in the academic life of the school):
EDUCATION
Please state your AS and A2 (or equivalent) subjects, and grades either known or expected (you must give
any grades already achieved):
Please list your extra-curricular interests and achievements:
Do you have a University/College place secured for after your gap year? Please state where you are
hoping to attend and which subject(s) you wish to study?
OTHER INFORMATION
What experience do you have of travelling either with family or on your own?
How did you hear about the Secondary School Exchange (you may list more than one option)? E.g.
Website, Poster, School, Facebook, Student Forum, other
PERSONAL STATEMENT
Please submit your Personal Statement on a separate sheet ensuring your name is on each additional
sheet. Please keep your personal statement to one side maximum.
Personal Statement Guidelines:
Your statement is the most important part of your application. It gives you the opportunity to introduce
yourself, and demonstrate why you are suited to, and interested in an SSE scholarship. You don’t need to
answer all of the following questions, but they are worth bearing in mind:
-
Why are you applying? What interests you about American life/politics/culture? What do you expect
to gain from the scholarship? Academically, culturally, socially etc.
-
How will a US school benefit from having you on roll?
-
Are you the kind of person who sticks with things and perseveres even when a situation is
challenging or stressful?
-
Are you a flexible person who finds it easy to adapt to a new environment with new rules and
expectations? If you are given a scholarship but none of your preferences are available will you still
be able to adapt?
DECLARATION
I have read and understood the notes and conditions for applying for a scholarship to the ESU. I declare
that the information given above is correct:
Signature:
Date: