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Tyumen Course Program
APPLICATION FORM
Personal Information
Last Name:
First Name:
Other Name:
Date of Birth:
Email Address:
Current Phone:
Mailing Address:
What is your country of citizenship?
What is your native language?
Parent/Guardian Information
Name: (First, Middle Initial, Last)
Relationship:
Current Phone:
Address:
Educational History
Academic Program/School:
Major:               GPA:  
Academic Interest(s)(no more than words):
Have you taken any Russian-language courses? Yes No
List the course(s):
Will you be taking any Russian-language courses during the Summer 2010 semester? Yes No
List the course(s):
Have you taken any Environmental-Science/Policy-related course(s)? Yes No
List the course(s):
Will you be taking any Environmental-Science/Policy-related courses during the Summer 2010? Yes No
List the course(s):
Additional Questions
Give three reasons why you want to participate (no more than words):
What are your expectations (no more than words):
What are your experiences living outside of the USA (no more than words):

Part of the experience of international travel includes different cultural norms. For instance, in Russia in the summer there are typically several weeks when whole areas of cities do not have hot water. It is unusual for a university building, hotel or private apartment to be air conditioned. Local residents normally use public transportation, walk long distances, and are accustomed to waiting a long time when they have to deal with a bureaucratic hurdle. As a participant in this overseas study program, you will experience day-to-day life as local residents do. (A) Will you be able to set aside your American expectations and welcome that experience, or (B) will it be difficult for you?
(A)
(B)
Statement
List the reasons for wanting to take the Global Environmental Issues/Language Learning Field Experience course and describe how it fits into your academic curriculum/program of study.
No less than and no more than words:

If you make our initial selection, we would request your availability for a phone/Skype/in-person interview. Will you be available for an interview? Yes No
AFFIRMATION STATEMENT
I understand that withholding pertinent information requested on this application or giving false information on this application will make me ineligible for admission, or will make me subject to cancellation of admission if admission has already been granted or dismissal if already enrolled. I certify that all statements on this application are correct and complete. I give my permission to officials at all institutions I have attended to release information needed by the University to substantiate statements I have made on this application:
I Agree

For additional information and/or questions contact:
Olena Chernishenko 812-855-3046 ochernis@indiana.edu
Vicky Meretsky meretsky@indiana.edu
Email is the preferred method of communication.


Indiana
                                 University
Department of Slavic Languages and Literatures
Ballantine Hall 502
1020 E. Kirkwood Ave. Bloomington, IN 47405-7103
Phone: (812) 855-2608

Comments: iuslavic@indiana.edu
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