Programs in the French Alps: Tufts Summit | APPLICATION form
APPLICANTS
1. Enclose a check for $75
payable to Tufts University
or complete the credit card
authorization on the other
side of this form.
2. Attach a photocopy of the
passport on which you
will travel to France (must
be valid until at least one
month beyond the conclusion of your program).
NAME
LastFirst
CURRENT MAILING ADDRESS
Number and Street
City
Current Address Valid Until
Sate
3. Have your high school
transcripts sent to the
address below.
Phone (include country code if not in U.S.)
4. Please respond to the
following three questions
in 3-4 pages total.
Date of Birth a) Why are you interested
in studying International
Relations?
b) P
lease tell us about your
interest in the French
language. What is your
favorite French word
and why?
c) If you could sit down with
one person that
you admire, who would
you pick and what would
you say?
Middle
Zip or Postal Code
E-mail Address
Place of Birth (city, state, country)
PERMANENT MAILING ADDRESS
 Check here if same as mailing address
Number and Street
City
State
Zip or Postal Code
Tufts European Center
108 Packard Avenue
Medford, MA 02155-7049 USA
Phone: 617.627.3290
Fax: 617.627.3457
E-mail: [email protected]
Country
Phone (include country code if not in U.S.)
FRENCH EXPERIENCE
How many years of­French have you studied? __ Middle School French __ High School French
 Other? Please explain below:
PRINT, SIGN AND RETURN
THIS FORM TO:
Country
CURRENT GRADE
High school student:  Sophomore  Junior
Please complete both sides of this form.
attach additional sheets if needed.
Programs in the French Alps: Tufts Summit | APPLICATION form
PARENTAL APPROVAL
Parent’s E-mail Address
Parental Approval (required of students not yet 18 years of age)
I hereby grant permission for my son or daughter to attend, if selected, the Tufts Summit program. I
understand the need for him/her to abide by the regulations of the program and university and that
there are consequences for failure to comply.
Parent Signature (Please print form and sign before submitting)Date
HOW DID YOU HEAR ABOUT US
How did you first learn about this program?
 Someone told me about it
 Saw an advertisement
Where?_____________________________________________________________
 Saw it listed in a directory/book/catalog
Which publication?______________________________________
 Received a brochure or flyer in the mail
 Searched the Internet
Which site? __________________________________________________________
 Attended an information session at Tufts
 Other (please specify)______________________________________________________________________
APPLICATION CHECKLIST
 Registration Form
 Three-part Personal Statement
 Check for $75 or
 Recommendation from your
credit card information
French teacher
 Photocopy of your passport
 Recommendation from a teacher
of your choice
 Housing Form
 4 Passport-sized photos
 Optional: Scholarship Form
 High School Transcript
Non-Refundable Application Fee (Upon acceptance, tuition will be billed directly by
Tufts University. Once processed, credit card information will not be kept on file.)
Credit card authorization PRINT, SIGN AND RETURN
THIS FORM TO:
Tufts European Center
108 Packard Avenue
Medford, MA 02155-7049 USA
Phone: 617.627.3290
Fax: 617.627.3457
E-mail: [email protected]
 Visa
 Mastercard  Discover
I authorize Tufts University to charge the following to my credit card account: Credit Card Account Number
 $75 Registration Fee
Expiration Date (mm/yy)
Cardholder’s Name (please print)Signature (print out form and sign)Date
Please complete both sides of this form.
attach additional sheets if needed.
Programs in the French Alps: Tufts Summit | HOUSING form
The information requested
on this form will be used to
help place you with an
appropriate host family. It is
important that you answer all
questions as thoroughly and
specifically as possible.
First Name
Gender:  Male
Last Name
 Female
Date of Birth
Country of Birth
Current Citizenship
Passport Number
Native Language
Parent(s) is/are:  Married  Single  Divorced
Please attach four
passport-size photos
here (for office
purposes only).
 Legally separated  Widowed
Father’s Occupation
Mother’s Occupation
Have you ever studied or traveled overseas?  Yes  No
If yes, please describe:
Do you have any brothers?
 Yes  No
Do you have any sisters?
 Yes  No If yes, how many?______________Age(s)? _______________
Describe your level of proficiency in French:
 None  Beginner  Advanced Beginner
If yes, how many?______________Age(s)? _______________
 Intermediate  Advanced  Fluent
Would you prefer to be placed with a family with children?
 Yes  No  No preference
Would you prefer to be placed:  Alone  With another student
(note: most students are placed with another student)
 No preference
Do you have any serious allergies to smoke, dust, pollen, food, animals, or medications?
 Yes  No If yes, please explain and be specific.
Do you smoke?  Yes  No If no, do you object to being roomed with a smoker?  Yes
Do you object to being placed in a home with smokers?  Yes  No
Do you have any dietary restrictions?
If yes, please explain and be specific.
 Yes  No
PRINT, SIGN AND RETURN
THIS FORM TO:
Tufts European Center
108 Packard Avenue
Medford, MA 02155-7049 USA
Phone: 617.627.3290
Fax: 617.627.3457
E-mail: [email protected]
Please complete both sides of this form.
attach additional sheets if needed.
 No
Programs in the French Alps: Tufts Summit | HOUSING form
The information requested on
this form will be used to help
place you with an appropriate
host family.
Do you have any physical ailments or limitations that make it difficult for you to climb stairs or walk long
distances?  Yes  No If yes, please describe.
Please rank in order of importance to you the following homestay components with 1 being the most important:
______
______
______
______
______
f_amily with children
_no smokers in household
_location of home
_having a roommate
_no pets in household
Describe any hobbies or interests that you would like to pursue while in France.
What is the most important quality you are looking for in a family situation?
What would you like your French family to know about you?
ETHNICITY (Optional)
If you wish to be identified with a particular ethnic group, please check one of
the following:
 African American, Black
 Puerto Rican
 Mexican American, Chicano
 Asian (Indian Subcontinent)
 American Indian, Alaskan Native
PRINT, SIGN AND RETURN
THIS FORM TO:
Tufts European Center
108 Packard Avenue
Medford, MA 02155-7049 USA
Phone: 617.627.3290
Fax: 617.627.3457
E-mail: [email protected]
(tribal affiliation____________________________)
 Native Hawaiian, Pacific Islander
 Asian American
(country of family’s origin____________________)
(country)______________________________)
 White or Caucasian
 Hispanic, Latino
(country)______________________________)
 Other
(Specify)______________________________)
Please complete both sides of this form.
attach additional sheets if needed.
Programs in the French Alps: Tufts Summit | FRENCH Recommendation form
APPLICANTS:
Please fill in your name, and
submit this form to your
French teacher.
NAME
TO THE PERSON COMPLETING
THIS RECOMMENDATION:
Your Name (please print)Title/School
The recommendation you
are submitting will be used
for selection purposes only.
It will not become part of the
student’s educational record.
Therefore, the applicant
will not have access to this
recommendation under law.
School’s Street Address
The student named above
is applying for admission
to a month-long summer
study abroad program
where students learn about
international relations
and improve their French
language skills. Students
live with a family in France
and enroll in two courses.
How long have you known this student and in what context?
It is important that a student
be both socially and
academically prepared for
this program. Your candid
appraisal of this student’s
readiness for the program
would be most appreciated.
Please attach a one-page letter evaluating this
student’s maturity and Academic readiness for
the program.
Student’s Name
City
State/Country
Day Phone Number
E-mail Address
Signature (print out form and sign)
Date
Zip Code
REFERENCE
PLEASE RATE THIS STUDENT IN COMPARISON WITH OTHER STUDENTS
YOU HAVE TAUGHT OR ADVISED ACCORDING TO THE FOLLOWING:
UNABLE
averagegoodexcellentoutstandingto rate
PLEASE PRINT, SIGN AND
RETURN BY MARCH 9 TO:
Tufts European Center
108 Packard Avenue
Medford, MA 02155-7049 USA
Phone: 617.627.3290
Fax: 617.627.3457
E-mail: [email protected]
Overall Rating
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Academic Ability
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
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Academic Motivation

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
Self-Discipline

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
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
Emotional Maturity
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Oral French Ability
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Written French Ability
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Programs in the French Alps: Tufts Summit | recommendation form 2
APPLICANTS:
Please fill in your name, and
then submit this form to
your guidance counselor or a
teacher who knows you well.
TO THE PERSON COMPLETING
THIS RECOMMENDATION:
The recommendation you
are submitting will be used
for selection purposes only.
It will not become part of the
student’s educational record.
Therefore, the applicant
will not have access to this
recommendation under law.
The student named above
is applying for admission
to a month-long summer
study abroad program
where students learn about
international relations
and improve their French
language skills. Students
live with a family in France
and enroll in two courses.
It is important that a student
be both socially and
academically prepared for
this program. Your candid
appraisal of this student’s
readiness for the program
would be most appreciated.
NAME
Student’s Name
Your Name (please print)Title/School
School’s Street Address
City
State/Country
Day Phone Number
E-mail Address
Signature (print out form and sign)
Date
Zip Code
REFERENCE
How long have you known this student and in what context?
Please attach a one-page letter evaluating this
student’s maturity and Academic readiness for
the program.
PLEASE RATE THIS STUDENT IN COMPARISON WITH OTHER STUDENTS
YOU HAVE TAUGHT OR ADVISED ACCORDING TO THE FOLLOWING:
UNABLE
averagegoodexcellentoutstandingto rate
PLEASE PRINT, SIGN AND
RETURN BY MARCH 9 TO:
Tufts European Center
108 Packard Avenue
Medford, MA 02155-7049 USA
Phone: 617.627.3290
Fax: 617.627.3457
E-mail: [email protected]
Overall Rating





Academic Ability





Academic Motivation





Self-Discipline





Emotional Maturity





Oral French Ability





Written French Ability




