EmailMe Form - International Student Advisor Application

Please Note: This form uses ReCaptcha (TM) technology to keep your information safe and strictly confidential.

Information on our International Business Week Programs can be found at: http://www.wbw.org/reader.aspx?pg=Programs_GDYNIA.htm

CONTACT INFORMATION

Student Name *

First Last

Mailing Address *

Street Address City State / Province / Region Postal / Zip Code Country

Student Home Phone *

### - ### - ####

Student Cell Phone *

### - ### - ####

Student Email *

School name *

Academic grade you will complete in June 2013 *

T-Shirt Size *

Activities

DECA

FBLA

Other

Place of Employment (if unemployed, leave blank)

Supervisor

Supervisor Phone Number

### - ### - ####

PARENT/GUARDIAN CONTACT INFORMATION

Parent/Guardian Name *

First Last

Parent/Guardian Phone *

### - ### - ####

Parent/Guardian Cell

### - ### - ####

Parent/Guardian Email *

POLAND BUSINESS WEEK CHOICES

City of Minsk Mazowiecki, Poland – June 30th – July 5th
(departing June 26th and returning July 8th)

City of Boleslawowo, Poland – July 14th – July 19th
(departing July 10th and returning July 22nd)

City of Gdansk, Poland – July 21st – July 26th
(departing July 17th and returning July 29th)

City of Gdynia, Poland – August 18th - August 26th
(departing August 14th and returning August 26th)

(Mark top two choices in order of preference.)

First Choice *

Minsk Mazowiecki

Boleslawowo

Gdansk

Gdynia

Second Choice *

Minsk Mazowiecki

Boleslawowo

Gdansk

Gdynia

PLEASE COMPLETE THE APPLICATION BELOW

1. CA Recommendation

We require a letter of recommendation from a Company Advisor. Please have the CA mail or email that letter directly to janice@wbw.org with your name included in the letter. If you need your CA’s contact information, email: registrar@wbw.org or contact Alisa Johnson at 253-815-6900.

Date I requested my CA send a letter of recommendation to WBW *

MM / DD / YYYY

2. Three words that describe your "philosphy of life":

One *

Two *

Three *

3. Essay

In 300 words or less, tell us why you want to be a student advisor at International Business Week as well as the skills/talents that you would bring to the team. You may want to tell us:
a. what you expect to learn from participating in this program;
b. why you want to participate in this program;
c. why we should select you to participate in this program;
d. what qualities or characteristics you feel you contribute to a team or group; and/or
e. any leadership experience you have.

Essay
(NOTE - you can also email this essay to janice@wbw.org.) *

4. Please tell us a little about yourself, such as: What activities and hobbies do you enjoy outside of school? What is your favorite sport? What are your favorite classes? *

5. I am interested in taking these courses in college:
(hold down ctrl key)

6. Who is one person you admire? Why? What does she/he do for living? *

7. List the three careers or jobs that interest you most

One *

Two *

Three *

8. Describe your international travel experience.

Do you have a current passport?

Yes

No

10. Is there anything else you should to tell us?

PAYMENT INFORMATION

Each Student Advisor will need to pay (or raise*) approximately $2,500 - a $1,000 program fee and approximately $1,500 to cover airfare and ground transportation expenses. Corporate and Polish sponsors pay the program & material costs, lodging, and food for Advisors during the week. You may send your $1,000 registration fee with this registration form. Your registration fee is due within three weeks of the date you receive notification that you are accepted into a program unless special arrangements have been made. Failure to pay the fee and turn in required forms may result in cancellation of the registration. (* Financial assistance will also be available to a limited number of participants.)

Please check all that apply:

I will pay the $1,000 registration fee within three weeks of receiving notice of acceptance into the program (unless I make special payment arrangements with WBW).

I am requesting financial assistance.

(To apply for financial assistance, please complete the WBW Financial Assistance Application which can be downloaded at http://www.wbw.org/reader.aspx?pg=FinancialAssistance.htm.)

I wish to make arrangements for a payment plan.

REFUND POLICY

• If you must cancel for any reason, please notify us as soon as possible. Cancelation notice must be in writing.
• You should consider getting travel insurance for your airfare and program expenses.
• A refund of the program fee is given if you cancel at least 3 weeks prior to the program.
• $500 will be refunded if you cancel less than 3 weeks prior to the start of the program.

PARENT AND STUDENT ACKNOWLEDGEMENT:

Typing my name below constitutes my acknowledgement.

If accepted, I agree to make a sincere effort to push myself and grow during the Poland Business Week Program.

Student Acknowledgement

First Last

I give my support and express permission for my student to attend Poland Business Week for the program dates indicated above.

Parent Acknowledgement

First Last

Please know that we cannot process your intern application until we have received this completed application, your essay, and a letter of recommendation from your Company Advisor.