Department of World Languages and Cultures

DEPARTMENT OF WORLD LANGUAGES AND CULTURES

APPLICATION FORM The Department of World Languages and Cultures grants a number of scholarships to its students. If you wish to apply, your application and all supporting materials (including a letter of recommendation) must be submitted by 3pm on Friday March 6, 2015 to the department secretary in 3102 Pearson Hall. NOTICE that an application must be submitted for each scholarship for which you are applying AS WELL AS A LETTER OF RECOMMENDATION FOR EACH SCHOLARSHIP.

For returning students for the summer or next academic year, please complete and submit this form to be considered for the following scholarships: - Van Iten Study Abroad Scholarship - Louise Semmons Scholarship - Alfred P. Kehlenbeck Scholarship - Ronald Schubert Scholarship - Sarah Dahlke Memorial Scholarship - A separate application form is used for the Ester Catherine Harmon Scholarship (see the LSRC website for more information regarding this scholarship).

SCHOLARSHIP APPLIED FOR:

______

BASIC INFORMATION:

Name (Last, First, Middle): _____ Date of Birth (MM-DD-YYYY): _____ University ID Number: _____ Local phone number: _____ Email address: _____ @iastate.edu Current Address: ______Permanent Address: ______High School Name and City: _____

Major: _____ Minor: _____ Current G.P.A. (Applicants’ G.P.A. should be 3.0 or higher in order to qualify): Classification as of next fall semester (e.g., sophomore, etc.): ______Expected Graduation Date: ______

Short Answer: Please list college and community organizations and activities, including volunteer services, in which you have participated during college: ______List any honors you have received:

______

List any full or part-time work experience you have had during the past three years:

Employer Type of work Dates

FOR VAN ITEN SCHOLARSHIP APPLICANTS

o G.P.A. in German ______o G.P.A. in remaining courses ______o Participation in Study Abroad YES NO If yes, where? ______o Please provide letter of acceptance or any other sort of documentation or evidence that proves that you are studying abroad.

FOR LOUISE SEMMONS SCHOLARSHIP APPLICANTS

o Are you a junior or senior language student? YES NO o List the foreign language activities on campus in which you have participated and the level of participation (i.e., state what your responsibilities were and how often you participated in the activity). Activity Responsibilities How often?

FOR ALFRED P. KEHLENBECK SCHOLARSHIP APPLICANTS o Are you a major in World Languages and Cultures? YES NO o Are you preparing to teach? YES NO o Are you planning to study and travel abroad within the next academic year? YES NO If yes, where? ______o Please provide a letter of acceptance or any other sort of documentation or evidence that proves that you are studying abroad. If you do not present this documentation you will not be eligible for this scholarship.

FOR SCHUBERT SCHOLARSHIP APPLICANTS o Describe how your background may be considered rural. For example, what is your relationship to a farm, if any? What activities did you participate in that suggest a rural background? Why do you consider your background rural? ______

Study Abroad Information (Please note that applicants for the Van Iten, Kehlenbeck, and Dahlke scholarships must study abroad in the following year.) Do you plan to participate in a study abroad experience while you are a student at Iowa State? YES NO If no: Skip to “Scholarship Data” section, below. If yes: Briefly describe the experience in which you are planning to participate:

______

During which term are you planning to participate? ______What are your reasons for participating? ______Scholarship Data:

Are you an active applicant for other scholarships outside of World Languages and Cultures? If so, list name and amount:

Name Amount

Were you awarded any scholarships for the upcoming academic year? If so, list name and amount:

Name Amount

Please describe your aspirations in your major field of study: ______

Supporting Materials: 1. Please submit one letter of recommendation from a professor or instructor. You may print copies from the online version of the recommendation form, refer your letter writer to the online version so that he or she may complete the form themselves, or use the form included with this application file. Whichever method you choose, the letters must accompany your application in a sealed envelope (PLEASE NOTE THAT YOU MUST SUBMIT ONE LETTER OF RECOMMENDATION FOR EACH APPLICATION. Applications without the correct number of letters will not be eligible) 2. Enclose a copy of your most recent transcript (does not have to be official) or a copy of your permanent record from AccessPlus.

The decisions of the Scholarship Committee are final and all applicants will be notified in early April. Scholarships will be awarded at the World Languages and Cultures Awards Ceremony on April 19, 2015. Awardees are expected to attend the Awards Ceremony.

The following information will be used for news releases in the event you are selected for a scholarship. This information will not be considered by the scholarship selection committee.

Name of hometown newspaper: ______Name of county seat or greater metro newspaper: ______Home County: ______Name (first and last) of parent(s) or guardian(s): ______Home address(es) of parent(s) or guardian(s): ______Home county(ies) of parent(s) or guardian(s): ______

DEPARTMENT OF WORLD LANGUAGES AND CULTURES

RECOMMENDATION FORM: Confidential

The Scholarship Committee desires full and accurate information about those who are applying for scholarships. You have had contact with this candidate as a teacher, advisor, employer, etc. Please comment on those qualities of this candidate with which you are most familiar. Feel free to provide your written comments on a separate sheet of paper. Thank you for your help with this important process!

Name of Scholarship: ______

Student’s Name:

Relationship with student (teacher, coach, advisor, etc.):

Please attach a brief letter of recommendation assessing the student’s abilities, i.e., dependability/maturity, effectiveness with written and oral expression, ability to work with others and probable success in their chosen field.

Name: Position:

Signature: Date:

Again, thank you for your help with this student’s application! Please return this form to the student who must then submit it by 3:00 p.m., Friday, March 6, 2015 to the secretary in the Department of World Languages and Cultures, 3102 Pearson Hall.