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C.U. in India and Southeast Asia Program
Submit your completed application via e-mail to SouthAsiaCenter@upenn.edu with the subject line reading “[Your First and Last Name] CUinIndia Application.” Your application will NOT be considered if it is misplaced due to an incorrect subject line. Applications due by March 24, 2017.

Name:
School: Major:


Expected Graduation Date (Mo/Yr): Telephone #:
Email Address:
How did you find out about this program?
Check the appropriate space regarding your citizenship or immigration status:
U.S. Citizen _______ U.S. Permanent Resident _______ Other: ___________________
INTERNATIONAL EXPERIENCE
Have your traveled outside the United States? (Not a requirement)  Yes ____ No ____
If so, please note the countries visited, purpose of visit, dates and length of each visit:

Please list languages and competency in each (language ability is not a requirement):

Which course (s) are you interested in (check up to two courses below)
The Performing Arts of Modern South India

Please answer the following questions briefly (less than 200 words each) in a separately attached word document:


    1. Why are you interested in participating in C.U. in India and Southeast Asia (CUISA)?

    2. What do you specifically hope to gain from taking this course and what do you expect the impact of your participation will be on your career and/or studies?

    3. What concerns do you have about CUISA? How will you address these concerns if selected?

    4. Have you ever been in a situation where you were in close contact with a foreign culture? What challenges did you face? How did you benefit from this experience?

    5. Have you ever experienced emotional/mental fatigue from traveling with a group? If so, how did you deal with it? If not, how would you deal with it?

    6. Tell us about a time in which you encountered a challenge in a group setting. How did you resolve the situation?

    7. Name one positive and one negative personality trait that pertains to you? How do you think these traits will impact group dynamics? How will you self-manage challenging personality traits within yourself and others?




  1. Please attach your CV (include GPA).

ADDITIONAL INFORMATION


Health:
Travel to India and Southeast Asia can be physically challenging.  The average daily temperatures will range from 50-70° F. Participants must be able to endure travel with a moderate to high degree of rigor and the inconveniences of traveling in regions that may not have the amenities to which Americans are accustomed.  Participants are required to meet with Student Health Services regarding travel to India and/or Southeast Asia, and receive medical clearance from their own primary care physician.  Note in advance that inoculations for travel are excluded under many health insurance policies. Participants are required to obtain any inoculations or prophylaxis recommended by SHS at their own cost.
Next Steps:
Once the completed application is received, prospective candidates will be contacted for an interview. Participants will be asked to sign a contract stating that they will attend all of the scheduled activities associated with the program overseas and the United States.
SIGNATURE

I certify that the information I provided on this application is correct to the best of my ability and that I agree to the terms and conditions of the program if selected.


____________________________________
Student Signature



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