Financial Aid and Scholarship Application Form

Name: _____________________________________ E-mail: ________________________ Gender: _____

Local Address: __________________________________________________________( ) ___________

Street/Residence Hall City State Zip Telephone

Home Address: __________________________________________________________( ) ___________

Street/Residence Hall City State Zip Telephone

Country: ________________________________ Nationality: ___________________________________

Date of Birth: _____________________________ Social Security Number: ________________________

College: _____________________ Major: _______________ Academic Status: Fresh. Soph. Jr. Sr. Grad.

G.P.A (Cumulative): ______ US Citizen/Permanent Residence Yes No

Which Semester Abroad are you Considering? Spring 2003 Fall 2003 Spring 2004 Fall 2004

What Financial Aid are you currently receiving? (please include the name, amount and any other comment)

______________________________________________________________________________________

What Financial Aid do you need to attend The Abbey Program (please give dollar amounts and total them):

Scholarships: $ ____________

Loans: $ ____________

Other (specify): $ ____________

TOTAL: $ ____________

Please attach the following:

A brief summary of your interests, strengths, ideas, and questions.

Submit as soon as possible to:

Ms. Amy C. Albert

President

The International Education Initiative

32500 Telegraph Rd.

Suite 209

Bingham Farms, MI 48025

(248) 988-9341 (Telephone)

(248) 723-3341 (Fax)