Phone: +27 11 783 5876 SMS: +27 84 288 3666 Fax: +27 11 252 6190 [email protected] www.africanleadershipacademy.org PostNet Suite 413, Private Bag X1 Northcliff 2115 South Africa ______

WELCOME TO AFRICAN LEADERSHIP ACADEMY!

Dear Applicant,

Thank you for your interest in African Leadership Academy. By completing this first-round application you are taking the first step in a process that will allow us to learn more about you, your achievements, and your future goals.

Prior to completing this application, I encourage you to learn as much as possible about African Leadership Academy. Read our brochure, ask us questions, or visit our website: www.africanleadershipacademy.org. Think about the role you envision playing in Africa’s future. If you believe African Leadership Academy is the right place for you, take the next step and apply!

We encourage you to submit your application as soon as possible. All first-round applications must be received at our office in South Africa by 01 December 2009. Our Selection Committee will review all first-round applications carefully and nominate finalists by late January 2010. All finalists will be invited to submit a final-round application that includes additional personal information, essays, and recommendation letters. The last step in the process may include an entrance exam and interviews. All finalists will be notified of final admissions decisions by mid-April 2010.

We are excited that you have chosen to apply to African Leadership Academy, and wish you continued success as you pursue your dreams.

Warm regards, Dean Chris Khaemba

FIRST-ROUND APPLICATION INSTRUCTIONS

The African Leadership Academy first-round application consists of four components, all of which must be completed. We cannot evaluate applications that are incomplete. A. Personal Data Form B. Academic Information (including your last two school reports and national exam results) C. Short Answer Questions D. Essay Question

Submitting Your Application: Please complete the following three pages and attach copies of your last two school reports and national exam results. Be sure to write your name and contact information on each page of your application. You can submit your application to the African Leadership Academy Admissions Office in one of four ways:  Via email to [email protected]. (This is the preferred method!)  Via fax to +27 11 252 6190  Via certified courier to African Leadership Academy, 86 John Vorster Road, Microtek House, Right Wing, First Floor, Randpark Ridge, 2169 South Africa. Please list “Carl Owens” as the receiver and write +27 11 783 5876 for the receiver’s phone number.  If you cannot use any of the above methods, please submit your application via regular postal mail to PostNet Suite 413, Private Bag X1, Northcliff, 2115 South Africa. Please only use regular postal mail as a last resort.

Deadline: 31 Janvier 2010 All first-round applications with all four parts completed must be received by 31 Janvier 2010 . We strongly encourage you to submit your application as soon as possible. We cannot evaluate applications that arrive at the Admissions Office after the deadline.

Confirmation of Receipt: You will receive a confirmation via SMS and/or email after we receive your application. Please contact the Admissions Office only if you do not receive a confirmation message within one week. Please keep a full copy of all application materials in case your application is lost in transit. African Leadership Academy First-Round Application 2010 Page 2

A. PERSONAL DATA FORM STUDENT INFORMATION (Please type or write clearly in black ink using only CAPITAL LETTERS!) Surname (Family Name): First Names (Given Names): Gender: F M Nationality: Birth Date: / / Day Month Year Email Mobile Phone: (+ ) Other Phone: (+ ) Country code Country code Permanent Physical Address: Country Address During School Year: (If Different) Country

PARENT/GUARDIAN INFORMATION Living with: Parent(s) Relative(s) Other Name(s)/Relationship to you: Phone & Email:

SCHOOL INFORMATION: School Name and Location (City/Country): Current Grade Level/Form/Year: Expected Date of Graduation (if you do not enter ALA): / Month Year School Year Begins: School Year Ends: Principal’s or Head of School’ Name: Principal’s or Head of School’s Phone & Email:

B. ACADEMIC INFORMATION Name of last public/national examinations written: Country of examination: Date of exam: / Month Year Exam results (list most recent end of year results if you have not taken a public exam): Subject Grade/Marks/Score Subject Grade/Marks/Score

PLEASE ATTACH COPIES OF THE LAST TWO SCHOOL REPORTS YOU RECEIVED AND YOUR OFFICIAL EXAMINATION RESULTS (IF YOU HAVE THEM) How did you first learn about African Leadership Academy? (please mark only one) Information session / presentation (please specify location): Teacher, principal or counsellor (please list name): Friend, parent, guardian or relative (please specify and list name): Your own search on the Internet Other, e.g. newspaper, magazine, radio (please specify):

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Name: Phone/Email: C. SHORT ANSWER QUESTIONS Note: please contain all answers to the boxes provided.

What excites you most about African Leadership Academy?

What do you consider your greatest achievement so far?

List any activities you participate in at school or in your community and any leadership positions held.

What activity do you enjoy most and why?

Describe yourself. You may use words, pictures, symbols, equations – anything you would like.

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Name: Phone/Email: D. ESSAY QUESTION

Describe a time when you identified a need in your community (such as your family, school, village, or town). What did you do about it? Please limit your essay to the box provided.

I hereby certify that all information is truthfully and accurately presented and my work alone. Applicant Signature: Date:

I hereby give permission for my son / daughter / ward to apply to African Leadership Academy.

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Parent/Guardian Signature: Date:

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