Spring and Summer 2021 Application: Indonesia

Personal Information

Completed applications must be submitted by Friday, Nov. 2, 2020, at 4 p.m.

First Name *

Last Name *

Local Address *

City *

State *

Zip Code *

Phone Number *

Email Address *

Academic Information

College of Education degree and program area of study *

Anticipated graduation date *

Describe your experiences with clinicals, internships, or other practical professional experiences related to your degree. *

Provide all clinical, internship, and/or practical experiences you will have completed by May 2021. *

	Semester	Grade Level	# of Days per Week	Total Hours	Location	Supervisor Name
1.	Semester	Grade Level	# of Days per Week	Total Hours	Location	Supervisor Name
2.	Semester	Grade Level	# of Days per Week	Total Hours	Location	Supervisor Name
3.	Semester	Grade Level	# of Days per Week	Total Hours	Location	Supervisor Name
4.	Semester	Grade Level	# of Days per Week	Total Hours	Location	Supervisor Name
5.	Semester	Grade Level	# of Days per Week	Total Hours	Location	Supervisor Name
6.	Semester	Grade Level	# of Days per Week	Total Hours	Location	Supervisor Name

NIU References

Please provide the names and contact information for three different references that we may contact to gain additional insight on your candidacy. *

	Name	Department/Title	Phone	Email
Observed you teaching or working in groups	Name	Department/Title	Phone	Email
Speak to your ability to work with diverse student populations	Name	Department/Title	Phone	Email
Speak to your disposition on learning or teaching	Name	Department/Title	Phone	Email

Essay

Please upload an essay (3 page maximum, double-spaced, twelve point font) addressing the following questions:

Why do you feel you are a good candidate for this experience? Please speak to cultural awareness, self-awareness, and approach to differences/diversity.
Experiencing a new and different culture takes a great deal of mental fortitude. Describe a situation where you experienced significant uncertainty which required you to have strong perseverance in order to succeed.

Organization, grammar and spelling will also be assessed in addition to content.

*

Interview Process

Following the review of all application materials, applicants will be notified of their status on Tuesday, Nov. 10, 2020, via email.

Selected candidates will be invited to attend a required one-hour group interview with selection committee members. The tentative group interview date is Friday, Nov. 13, 2020, between the hours of noon to 5 p.m.

Please select your availability for an interview (check all that apply) *

Noon

1:15 p.m.

2:30 p.m.

3:45 p.m.

Acceptance

I certify by my signature that to the best of my knowledge, I have provided full information concerning all questions on this application. I am a native or near-native English speaker. I further understand that failure to provide true and complete information could mean rejection and/or revocation of acceptance of my application.

If selected to participate, I agree to the following:

Attend an extensive pre-departure orientation program from January through departure.
Complete a written evaluation summarizing my experience
Participate in post sessions to share experiences.
Provide data for research projects related to Educate Global.

I give the committee permission to review/access my academic records for the purpose of selecting finalists. Furthermore, I waive my right to review my references’ assessments and give permission to the selection committee to solicit additional references beyond the names that I have provided.

I also certify by my signature below that I agree that I will represent the NIU College of Education in a professional manner if awarded the opportunity to travel to another country. I will comply with all NIU, country of placement and sponsoring university policies and procedures. (All policies and procedures will be supplied to the candidate during orientation prior to the trip.)

Signature *

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