Global Experience Program Application (South Africa)

NOAH – Durban, South AfricaJuly 30 to August 21, 2010

Student Name: ______________________________________________________________________________________________

First Name Family Name Preferred Name

Date of Birth:____________________________________ Age:__________ Grade: ____________

Day/Month/Year

Address: __________________________________________________________________________________________________

Boarder Day Girl

Parents’ Names:

Mother:___________________________________ Father:_________________________________

Guardian’s Names (if boarder): __________________________________________________

List five adjectives that describe you: __________________________________________________

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What are your favourite subjects? ______________________________________________________

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Do you belong to any clubs or sports teams? ___________________________________________

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Leadership experience (inside or outside of Havergal): _________________________________

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Community outreach experience (inside or outside of Havergal):__________________________________________

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Activities you enjoy: ___________________________________________________________________________________________

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1) Please use the space below to explain what motivated you to apply for the Global Experience Program. What do you hope to gain or learn from this opportunity?

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a) What experience do you have in working with children?

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b) What did you gain from these experiences?

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2) How will you be a good ambassador for Havergal College while in South Africa? What is the role of an ambassador?

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3) Please describe any previous international travel experience you may have had. What have you found meaningful about travelling?

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4) How flexible and adaptable are you in a foreign environment? Please provide a specific example.

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5) What challenges do you think you may have to face on this experience?

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7) How will you prepare yourself for this experience?

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8) In your opinion, why should you be chosen for this opportunity?

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Student signature: ________________________________________________________ Date: ___________________________

I support my daughter's application and understand that her participation in the Global Experience Program involves my daughter being billeted with the family of a Durban Girls’ College I also understand that this application represents a commitment to the program. We will not withdraw from the program if my daughter is selected, unless exceptional circumstances arise and we have permission from the Principal.

Parent/Guardian name: _____________________________________________________(Please print)

Parent/Guardian signature: _____________________________________________________ Date: ___________________________

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