APRISE Study Tour Application

I. Personal Information
Name *FirstLast
Middle Initial*
Phone Number*###-###-####
USC Student ID #*
Email*
Ed.D. Program Concentration*
May the APRISE office release your name and contact information to other students, such as
other participants in your program and future participants?*

YesNo
May the APRISE office use images of you taken on the tour for the website?*

YesNo
Address*

Street AddressAddress Line 2CityState / Province / RegionPostal / Zip Code
Country
Daytime Phone###-###-####
Evening Phone###-###-####
What is the applicant’s citizenship?*
Dietary needs (e.g. vegetarian)
Person to contact in case of emergency*FirstLast
Emergency contact person’s phone numbers*###-###-####
###–###–####
relationship to you*
II. Program Information
For what trip are you applying (check one)? *
*

August 5-14, 2011 Ed.D. Study Tour to Delhi (focused on K-12 and higher education) – Applications due May 10August 5-14, 2011, Ed.D. Study Tour to Buenos Aires and Santiago (focused on K-12 and higher education) – Applications due May 10
III. Please respond to the following questions:
Please state why you are interested in participating in a study tour and what you are hoping to gain from the experience, particularly on the program you selected.*
Please describe your research interests and areas of practitioner interest.*
Please describe your previous international experiences.*
Please provide any special accommodations or considerations that you would like for the APRISE staff to know when planning for your participation on the tour.*
IV. Fellowships

A limited number of fellowships in the amount of $500-$1,000 each will be awarded on a competitive basis. Fellowship awardees will be selected on the basis of merit as well as special circumstances. If you are interested in applying for one of these fellowships, please respond to the following questions.
A. What will you gain by this international experience and how will it help you in your present and possible future career positions?
B. What is your proposal topic and how will this international experience relate to it?
C.Are there other considerations you would like to share with us?
Do Not Fill This Out

APRISE Study Tour Application

I. Personal Information

II. Program Information

III. Please respond to the following questions:

IV. Fellowships