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2014 CGE APPLICATION INSTRUCTIONS
Thank you for your interest in USIL’s Center for Global Education. Following is a list of materials
you must complete and submit in order to be considered for admission to CAE.
Keep in mind that in order to be considered for a scholarship, all application materials (including
school transcripts and teacher evaluations) must be submitted by no later than October 31, 2013.
Early admission: September 28th
Please check this box if you wish to be considered for a merit-based scholarship
The PERT test, required for admission, can be taken on one of the following dates:
The examination will take place in room C1E206
1)
2)
3)
4)
5)
6)
Friday, September 19
09:00 am - 01:00 pm
Wednesday, September 24
2:00 pm - 6:00 pm
Friday, October 10
09:00 am - 01:00 pm
Friday, October 17
09:00 am - 01:00 pm
Friday, November 7
09:00 am - 01:00 pm
Friday, November 14
2:00 pm - 6:00 pm
You can register for the date that is most convenient for you at www.usil.edu/pe/center/pert
Please go to the Admissions Office located on campus 1 on the day of the test to sign in.
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Complete the application for admission to the Center for Global Education
Personal Essay (instructions are located on page 4 of the application)
Fill out the applicant portion of the teacher evaluation forms and give them and their
corresponding envelopes to your selected teachers for completion; you must submit at
least 2 evaluations, and may submit up to 3. Do not forget to ask your evaluator to
place the completed evaluations in the envelopes provided, and to seal, stamp and sign
the envelope. DO NOT MAIL THE EVALUATIONS. They must be submitted together with
your completed application materials.
Register to take the PERT test on one of the dates shown above
Request official copies of your transcripts from your colegio /high school and submit them
along with your application. If they are not available, they may be submitted at a later
date.
Upon receipt of your completed application, we will contact you to arrange a personal
interview.
THE CENTER FOR G L O B A L
EDUCATION
APPLICATION & SCHOLARSHIP CHECKLIST
The Center for Global Education Application
Personal Essay (instructions can be found on page 4 of the application)
Official transcripts from all schools attended (if they are not available, they may be
submitted at a later date)
Teacher evaluation forms (two required)
PERT test scores (Do not forget to register for the test by logging on to
www.usil.edu/pe/center/pert Please go to the Admissions Office located on
campus 1 on the day of the test to sign in. Register to take the test on one of the
following dates:
-The examination will take place in room C1E206
1)
2)
3)
4)
5)
4)
Friday, September 19
09:00 am - 01:00 pm
Wednesday, September 24
Friday, October 10
Friday, October 17
02:00 pm - 06:00 pm
09:00 am - 01:00 pm
09:00 am - 01:00 pm
Friday, November 7
09:00 am - 01:00 pm
Friday, November 14 2:00 pm - 6:00 pm
Upon receipt of your completed application, we will contact you to schedule a
personal interview
Please check this box if you wish to be considered for a merit-based scholarship
2014 APPLICATION FOR ADMISSION
APPLICANT
Legal Name ______________________________________________________________________________________________________
Last/Family/Sur (Enter name exactly as it appears on official documents.) First/Given
Middle (complete) Jr etc.
Preferred name, if not first name (choose only one) ____________________________
Birth Date _____________________O Female O Male
mm/dd/yyyy
Former last name(s), if any____________________
US Social Security Number (if any) or DNI____________________________
Optional, unless applying for US Federal financial aid with the FAFSA form
Preferred Telephone O Home O Cell Home (_______) __________________________________ Cell (_______) ______________________
Area/Country/City Code
Area/Country/City Code
E-mail Address ____________________________________________________________________________________________________
Permanent home address ____________________________________________________________________________________________
Number & Street
Apartment #
_________________________________________________________________________________________________________________
City/Town
County or Parish
State/Province
Country
ZIP/Postal Code
If different from above, please give your current mailing address for all admission correspondence.
(from ___________ to __________)
(mm/dd/yyyY) (mm/dd/yyyy)
Current mailing address _____________________________________________________________________________________________
Number & Street
Apartment #
_________________________________________________________________________________________________________________
City/Town
County or Parish
State/Province
Country
ZIP/Postal Code
If your current mailing address is a boarding school, include name of school here: ________________________________________________
EDUCATION
Secondary Schools
Current or most recent secondary school attended ________________________________________________________________________
Entry Date ___________ Graduation Date ___________ School Type: O Public O Charter O Independent/private O Religious
mm/yyyy
mm/yyyy
Address __________________________________________________________________________________________________________
Number & Street
_________________________________________________________________________________________________________________
City/Town
State/Province
Country
ZIP/Postal Code
Counselor’s Name (Mr./Ms./Dr., etc.) ____________________________________________ Counselor’s Title _________________________
E-mail ____________________________________ Telephone (_______) ______________________ Fax (_______) ___________________
Area/Country/City Code Number Ext.
Area/Country/City Code Number
List all other secondary schools you have attended since 9th grade, including summer schools or enrichment programs hosted on a secondary
school campus:
School Name
Location (Address)
Dates Attended (mm/yyyy)
___________________________________ _______________________________________________ ______________________________
___________________________________ _______________________________________________ ______________________________
___________________________________ _______________________________________________ ______________________________
2014 The Center for Global Education
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ACADEMICS
While the following tests are not required for admission to the CGE program, if you have taken one, please report your Please indicate the
highest scores obtained. If you have not taken any of the tests listed below, please leave this section blank.
Grades
Class Rank _________ Class Size _________ Weighted? O Yes O No
(if available)
ACT Exam Dates: ________ ________ ________
(past & future)
mm/yyyy mm/yyyy mm/yyyy
GPA ________ Scale _______ Weighted? O Yes O No
(if available)
Best Scores: _________ ______ _________ ______ _________ ______
COMP
mm/yyyy English mm/yyyy Math mm/yyyy
_________ ______ _________ ______ _________ ______
Reading mm/yyyy Science mm/yyyy Writing mm/yyyy
SAT
TOEFL/
IELTS
Exam Dates: ________ ________ ________
(past & future) mm/yyyy mm/yyyy mm/yyyy
Exam Dates: ________ ________ ________
(past & future) mm/yyyy mm/yyyy mm/yyyy
Best Scores: ________ ______ _________ ______ _________ ______
(so far) Critical Reading mm/yyyy Math mm/yyyy Writing mm/yyyy
Best Score: _________ ______ ______
(so far)
Test
Score mm/yyyy
AP/IB/SAT Best Scores: ________ __________________________________ _____ ________ ____________________________ ______
Subject(per subject, so far) mm/yyyy
Type & Subject
Score mm/yyyy
Type & Subject
Score
________ ______________________________ _____ ________ __________________________________ ______
mm/yyyy
Type & Subject
Score mm/yyyy
Type & Subject
Score
________ ______________________________ _____ ________ __________________________________ ______
mm/yyyy
Type & Subject
Score mm/yyyy
Type & Subject
Score
________ ______________________________ _____ ________ __________________________________ ______
mm/yyyy
Type & Subject
Score mm/yyyy
Type & Subject
Score
Current Courses Please indicate title, level (AP, IB, advanced honors, etc.) and credit value of all courses you are taking this year. Indicate
quarter classes taken in the same semester on the appropriate semester line.
First Semester/Trimester
Second Semester/Trimester
Third Trimester
or additional first/second term courses if more
space is needed
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2014 The Center for Global Education
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Honors Briefly list any academic distinctions or honors you have received since the 9th grade or international equivalent (e.g., National Merit,
Cum Laude Society).
Grade level or
post-graduate (PG)
Honor
Level of Recognition
9 10 11 12 PG
School State/ National InterRegional
nacional
O O O O O ________________________________________________________________________ O
O
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O
O O O O O ________________________________________________________________________
O
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O O O O O ________________________________________________________________________
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O O O O O ________________________________________________________________________
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O O O O O ________________________________________________________________________
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EXTRACURRICULAR ACTIVITIES & WORK EXPERIENCE
Extracurricular Please list your principal extracurricular, volunteer, and work activities in their order of importance to you. Feel free to
group your activities and paid work experience separately if you prefer. Use the space available to provide details of your activities and
accomplishments (specific events, varsity letter, musical instrument, employer, etc.). To allow us to focus on the highlights of your
activities, please complete this section even if you plan to attach a résumé.
Grade level or
post-graduate (PG)
9 10 11 12 PG
Approximate
time spent
Hours
per week
O O O O O ________
When did you participe
in the activity?
Weeks School
per year year
________
O
Summer/
School
Break
O
If applicable,do
you plan to
participate in
in college?
______________________________________________________
O
Activity _________________________________________________________________________________________________________
O O O O O ________
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Activity _________________________________________________________________________________________________________
O O O O O ________
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Activity _________________________________________________________________________________________________________
O O O O O ________
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Activity _________________________________________________________________________________________________________
O O O O O ________
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Activity _________________________________________________________________________________________________________
O O O O O ________
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Activity _________________________________________________________________________________________________________
O O O O O ________
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Activity _________________________________________________________________________________________________________
O O O O O ________
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Activity _________________________________________________________________________________________________________
O O O O O ________
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Activity _________________________________________________________________________________________________________
O O O O O ________
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Activity _________________________________________________________________________________________________________
2014 The Center for Global Education
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Personal Essay Please write an essay (500 words) on a topic of your choice or on one of the options listed below, and attach it to your
application before submission. Please indicate your topic by checking the appropriate box. This personal essay helps us become
acquainted with you as a person and student, apart from courses, grades, test scores, and other objective data. It will also demonstrate your
ability to organize your thoughts and express yourself.
NOTE: Your Common Application essay should be the same for all colleges. Do not customize it in any way for individual colleges. Colleges
that want customized essay responses will ask for them on a supplement form.
O 1 Evaluate a significant experience, achievement, risk you have taken, or ethical dilemma you have faced and its impact on you.
O 2 Discuss some issue of personal, local, national, or international concern and its importance to you.
O 3 Indicate a person who has had a significant influence on you, and describe that influence.
O 4 Describe a character in fiction, a historical figure, or a creative work (as in art, music, science, etc.) that has had an influence on you, and
explain that influence.
O 5 A range of academic interests, personal perspectives, and life experiences adds much to the educational mix. Given your personal
background, describe an experience that illustrates what you would bring to the diversity in a college community or an encounter that
demonstrated the importance of diversity to you.
O 6 Topic of your choice.
Additional Information If there is any additional information you’d like to provide regarding special circumstances, additional qualifications,
etc., please do so in the space below or on an attached sheet.
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
Disciplinary History
1 Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from 9th grade (or the
international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in your probation,
suspension, removal, dismissal, or expulsion from the institution? _ Yes _ No
2 Have you ever been adjudicated guilty or convicted of a misdemeanor, felony, or other crime? _ Yes _ No
[Note that you are not required to answer “yes” to this question, or provide an explanation, if the criminal adjudication or conviction has been
expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise ordered by a court to be kept confidential.]
If you answered “yes” to either or both questions, please attach a separate sheet of paper that gives the approximate date of each incident,
explains the circumstances, and reflects on what you learned from the experience.
SIGNATURE
Required Signature
□ I certify that all information submitted in the admission process-including the application, the personal essay, any supplements, and any
other supporting materials-is my own work, factually true, and honestly presented, and that these documents will become the property of the
institutions to which I am applying and will not be returned to me. I understand that I may be subject to a range of possible disciplinary actions,
including admission revocation, expulsion, or revocation of course credit, grades, and degree should the information I have certified be false.
□ I acknowledge that I have reviewed the application instructions for each college receiving this application. I understand that all offers of
admission are conditional, pending receipt of final transcripts showing work comparable in quality to that upon which the offer was based, as
well as honorable dismissal from the school.
□ I affirm that I will send an enrollment deposit (or equivalent) to only one institution; sending multiple deposits (or equivalent) may result in the
withdrawal of my admission offers from all institutions. [Note: students may send an enrollment deposit (or equivalent) to a second institution
where they have been admitted from the waitlist, provided that they inform the first institution that they will no longer be enrolling.]
Signature ________________________________________________________ Date ___________________
mm/dd/yyy
USIL’S Center for Global Education admission office does not discriminate on the basis of race, color, ethnicity, national origin, religion,
creed, sex,age, marital status, parental status, physical disability, learning disability, political affiliation, veteran status, or sexual orientation.
2014 The Center for Global Education
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2014 TEACHER EVALUATION
TO THE APPLICANT
After completing all of the relevant questions below, give this form and its corresponding envelope to a teacher who has taught you an
academic subject (for example, English, foreign language, math, science, or social studies). Ask them to complete the form and return it to
you in the envelope provided. The envelope should be sealed, stamped, and signed by your teacher. Please submit all teacher evaluations
together with your completed application
O Female
Legal Name __________________________________________________________________________________________________ O Male
st/Family/Sur (Enter name exactly as it appears on official documents.)
First/Given
Middle (complete)
Jr., etc.
Birth Date __________________________________________________________ Social security / DNI ____________________________
mm/dd/yyyy
(Opcional)
Adrress _________________________________________________________________________________________________________
Number & Street
Apartment
City Town
State/Province
Country
ZIP/Postal Code
School you now attend______________________________________________________________________________________________
IMPORTANT PRIVACY NOTICE: Under the terms of the Family Educational Rights and Privacy Act (FERPA), after you matriculate you
will have access to this form and all other recommendations and supporting documents submitted by you and on your behalf after
matriculating, unless at least one of the following is true:
1. The institution does not save recommendations post-matriculation (see list at www.commonapp.org/FERPA).
2. You waive your right to access below, regardless of the institution to which it is sent:
O Yes, I do waive my right to access, and I understand I will never see this form or any other recommendations submitted by me or on my
behalf.
O No, I do not waive my right to access, and I may someday choose to see this form or any other recommendations or supporting
documents submitted by me or on my behalf to the institution at which I'm enrolling, if that institution saves them after I matriculate.
Required Signature ______________________________________________________________________ Date _________________
TO THE TEACHER
The Center for Global Education at USIL finds candid evaluations helpful in choosing from among highly qualified candidates. You are
encouraged to keep this form in your private files for use should the student need additional recommendations. Please submit your references
promptly, and remember to sign below.
Teacher’s Name (Mr./Ms./Dr., etc.) _________________________________ Subject Taught _______________________________________
Please print or type
Signature _______________________________________________________________________________ Date _____________________
mm/dd/yyyy
Secondary School __________________________________________________________________________________________________
School Address ____________________________________________________________________________________________________
Number & Street
City/Town
State/Province
Country
ZIP/Postal Code
Teacher’s Phone (_______) ______________________________________ Teacher’s E-mail _____________________________________
Area Code
Number
Ext.
Background Information
How long have you known this student and in what context? _________________________________________________________________
What are the first words that come to your mind to describe this student? _______________________________________________________
List the courses you have taught this student, noting for each the student’s year in school (10th, 11th, 12th; first-year, sophomore; etc.) and the
level of course difficulty (AP, IB, accelerated, honors, elective; 100-level, 200-level, etc.).
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
2014 The Center for Global Education
TEACHER EVALUATION 1
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Ratings Compared to other students in his or her class year, how do you rate this student in terms of:
Very good
Good
(well above
Below average Average (adove average) average)
No basis
Excellent Ouststanding
(top 10%)
(top 5%)
One of the top few
I’ve encountered
(top 1%)
Academic
achievement
Intellectual promise
Quality of writing
Creative, original
thought
Productive class
discussion
Respect accorded by
faculty
Disciplined work
habits
Maturity
Motivation
Leadership
Integrity
Reaction to setbacks
Concern for others
Self-confidence
Initiative,
independence
OVERALL
Evaluation Please write whatever you think is important about this student, including a description of academic and personal characteristics,
as demonstrated in your classroom. We welcome information that will help us to differentiate this student from others. (Feel free to attach an
additional sheet or another reference you may have prepared on behalf of this student.)
2014 The Center for Global Education
TEACHER EVALUATION 1
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