<p>2018 Between the Lines: Peace and the Writing Experience Student Application</p><p>Applicant Name</p><p>Name of School/University Current Year of Study </p><p>Age</p><p>Gender</p><p>Governorate</p><p>Application Deadline: February 26, 2018 In order for your application to be complete, please make sure you have:</p><p>1) Completed Application Checklist Form (page 1)</p><p>2) Completed Application Form (this application form)</p><p>3) 1 Recommendation Letter. The recommender can be from a teacher/professor who is familiar with the writings of the applicant. The recommendation letter should be type- written and signed in English. </p><p>4) Copy of school/university transcript. Transcripts are the official document from the applicant’s school/university showing the student’s scores, grades, etc. for previous years of study. Please do not submit original transcripts. </p><p>5) Updated CV</p><p>6) Copy of passport or ID</p><p>7) Writing Samples: </p><p>A) A writing sample of 6-8 pages of prose (fiction or creative nonfiction) and/or poetry in English. Items must be unique and untranslated. Critical essays and other forms of nonfiction will not be accepted.</p><p>B) A writing sample of no more than 3 pages in response to the following:</p><p>In our daily lives, we navigate many different roles—student, sibling, daughter, son, peer. We negotiate family, friends, religious groups, as well as class, gender, race, country, and so many other groups, adjusting the way we speak or behave to fit the demands of each encounter. As we move through the day, we work through how and why we occupy each particular role. What do you consider to be the strongest, most central aspects of your identity? What does it mean to you to be a member of (or seen as a member of) a particular group? In what way does your identity influence you as a creative writer and reader?</p><p>C) A brief statement of purpose (no more than 250 words), written in English describing why writing is important to the applicant’s life, and what he/she hopes to learn at BTL.</p><p>Remark: All writing samples must be sent in 12-point font and have one-inch margins all around). </p><p> Late applications will not be considered. Applications can only be submitted by post, or in person as explained below. Applications sent electronically will not be considered. </p><p> Postal Submission: If you would like to submit your application by mail please send by some type of courier service that is dependable and requires signature upon delivery. Write your full name and list the program name on the envelope. </p><p> Hand Delivered Submission: Hand delivered applications will be accepted at the U.S. Embassy in Cairo. Applications must be HAND-delivered in OPEN envelopes to the Checkpoint guard at the North Gate of the U.S. Embassy (8, Kamal El Din Salah Street, Garden City), Sunday through Thursday between 11:00 a.m. and 2:00 p.m. (work days only*). Write your full name, list the program name and institute on the envelope.</p><p>*The US Embassy in Cairo closes on Fridays and Saturdays</p><p> If sending by post or hand delivery please use the following address: </p><p>U.S. Embassy in Cairo, Public Affairs Section, Exchanges Office</p><p>North Gate, 8 Kamal El Din Salah Street, Garden City, Cairo, Egypt</p><p> All application must be completed in full in English by the applicant. The application must be type-written; hand-written applications will not be accepted. Incomplete applications will not be considered.  All essays/writing should be type-written in English as required. Essays must be written in the applicant’s own words and not contain text taken from the Internet, books, or other sources. Applications containing even one sentence of plagiarized text will be disqualified automatically. For a definition of plagiarism please visit www.plagiarism.org for guidance on how to avoid plagiarism.</p><p>Remark: Only short-listed applicants will be contacted for interviews and will be asked to send their applications by e-mail. Please keep an electronic type-written copy of completed application.</p><p>For inquiries, please email [email protected] with the program name in the subject line. 2018 Between the Lines: Peace and the Writing Experience Student Application</p><p>Full Name (exactly as written in passport, if available):</p><p>Gender:</p><p>Date of Birth (mm/dd/yy):</p><p>City of Birth (exactly as written in passport, if available):</p><p>Country of Citizenship:</p><p>Country of Residency:</p><p>ID/Passport Number:</p><p>Home Address: </p><p>City of Residence:</p><p>Home Phone:</p><p>Mobile:</p><p>E-mail:</p><p>Are your fluent in any other languages other than English? If yes, please list:</p><p>Please indicate any scholarships, academic awards, honors, prizes, leadership roles or other recognition that you have achieved and the year received: Education History</p><p>School and University Degree Received Dates of attendance</p><p>City, Country And Date Received MM/YY – MM/YY</p><p>From: To:</p><p>From: To:</p><p>NON-Academic/Extra Curricular Activities</p><p>Please list community service, internships, professional training, jobs, sports, summer camps attended or cultural activities in which you have participated regularly in the past two years. This includes any service as a team leader, council member, or officer in any institution or activity.</p><p>Institution Name, Dates of City, Country Activity and Your Role Participation MM/YY – MM/YY</p><p>From: To:</p><p>From: To:</p><p>Emergency Contact Information Provide the names and contact information of individuals who should be notified in case of an emergency.</p><p>Name:</p><p>Relationship to applicant: </p><p>Street Address:</p><p>City:</p><p>Telephone Number:</p><p>E-mail address:</p><p>Family Background</p><p>Complete the following regarding your family:</p><p>Father’s Name: </p><p>Father’s Employment:</p><p>Employed Retired ______Year Unemployed </p><p>If employed or retired, Occupation: </p><p>Highest level of education attained: </p><p>None Number of secondary school years_____</p><p>Secondary Diploma Bachelor Degree Master Degree Ph.D.</p><p>Mother’s Name: </p><p>Mother’s Employment:</p><p>Employed Retired ______Year Unemployed </p><p>If employed or retired, Occupation: Highest level of education attained: </p><p>None Number of secondary school years_____</p><p>Secondary Diploma Bachelor Degree Master Degree Ph.D.</p><p>Memberships in Assocaitions, clubs, etc.</p><p>Name of Association/Club Membership Date</p><p>Travel experience to the United States or other countries</p><p>Please describe any previous travel or study outside of Egypt, including any summer Camps or Exchange programs participated in (if any):</p><p>Travel Dates Travel Purpose US Government MM/YY – MM/YY (e.g. vacation, school, etc.) Program? Y/N</p><p>From: To:</p><p>From: To:</p><p>How did you hear about the program? Facebook Study US Group </p><p>U.S. Embassy Website</p><p>Through Alumni of the same program</p><p>Other</p><p>SIGNATURE (by hand)</p><p>By my signature, I certify that, to the best of my knowledge, the information provided in my application is accurate and complete, and that I intend to return to my home country upon completion of my BTL program in the United States. </p><p>Signature:</p><p>Date:</p>