Multicultural and International Programs

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SECTION I: PERSONAL INFORMATION

Student Name: (last, first, middle)

Age:

Date of Birth:

Address:

Home Telephone:

Email (Checked regularly):

School Name:

Grade Completed by June 2008:

School Address:

GPA:


Ethnicity - Please check all that apply to you & CIRCLE the one that you most closely identify with:

[ ] African [ ] African-American [ ] Asian (specific ethnicity) [ ] Hispanic
[ ] Native-American [ ] Multi-racial [ ] Additional Option:

Please specify country of origin if applicable:

Please check below to indicate which FIRST STEP program you are applying for:
[ ] Residential Session I June 15th-June 20th *You must complete at least 96 out of 120 hours to graduate from program.
[ ] Residential Session II July 6th-11th*You must complete at least 96 out of 120 hours to graduate from program.
Please note that applications will be considered for both programs, unless otherwise noted!
Please check the box here [ ] if you are NOT interested in the other First Step program.


*STUDENT SIGNATURE: _______________________________________ *DATE:

Student currently resides with:

[ ] Both (parents: parent/step-parents)
[ ] Mother only
[ ] Father only
[ ] Guardian only

PRIMARY CONTACT:

Name:

Relationship to Student:

Occupation:

Employer:

Work Phone:

May we contact you at work? [ ] Yes [ ] No

SECONDARY CONTACT:

Name:

Relationship to Student:

Occupation:

Employer:

Work Phone:

May we contact you at work? [ ] Yes [ ] No

*Parent(s)/Guardian(s) Signature(s):

Signature:

*Date:

Signature:

*Date:

Section II: Student - Please complete.

1. How do you think you would benefit by being in Saint Catherine University’s FIRST STEP Summer Institute?



2. What are three words that you would use to describe the university experience? Explain why.




3. Why is it essential for you to attend university?




4. Please list some of your career goals upon completion of your university education.




Section III: Parent(s)/Guardian(s) - Please Complete

1. How did you hear about St. Catherine’s FIRST STEP Summer Institute?



2. How do you feel the FIRST STEP Summer Institute would benefit your student and why?



Section IV: Personal Essay - Type a 500-word essay (12-font, double-spaced) on one of the following topics:

1. What does it mean to you to be a women of color?How could the First Step Summer Institute help you be successful in going to university?
2. Who is the person in your family or community that inspires you the most? What is one important lesson you have learned from this individual?