Application for Admission Do not complete this form until you have obtained an
informational packet published for the summer you wish to be in
Cambridge from the program office. Directions are in the General
Instructions included with the materials.
* All fields are required *
Personal Data
First Name:
Middle Name:
Last Name:
Male
Female
Date of Birth:
Citizenship:
From time to time we will need to reach you
through the postal service, telephone, or e-mail. Please indicate below
how we can reach you when you are away from home at college, as well as
when you are at home.
Present or College Mailing Address:
City:
State: Zip Code:
Present or College Phone:
College email:
Permanent or Home Mailing Address:
City:
State: Zip Code:
Permanent or Home Phone:
Permanent or Home email:
Please indicate dates when we should send mail
to your school address and when we should send mail to your home
address, e.g., dates for winter break and the end of spring semester.
School Dates:
Winter Break Dates:
End of Semester:
Please indicate someone who we may contact in case of an emergency.
Emergency Contact:
Address:
City:
State: Zip Code:
Phone:
Relationship:
Each application must be accompanied by a letter
of recommendation from a faculty member. Please give the name and
address of this person below.
Name:
Department:
Phone:
Position:
Name of Institution:
How did you hear of the Cambridge Program?
Academic Information Be sure to provide a transcript from EACH college/university you have attended.
Current College:
Major: Year in College:
Expected Date of Graduation:
Other College:
Dates of Attendence:
Other College:
Dates of Attendence:
Scholarships or any other academic honors:
Personal Statement In 100 words or more, please state your reasons for
wishing to study abroad (career plans, future teaching or diplomatic
work, satisfy your major requirements, general cultural interest, etc.).
Write as
much as you like-these boxes hold more than meets the eye.
We recognize that we may not have given you an
opportunity to share with us all of the information (nonacademic
interests or achievements) that you consider to be important in our
review of your application. If this is true, please make an additional
statement in the space below.
Course Selection
Please list below the two courses which you would
prefer to take, and at least two alternatives. Refer to the Faculty and
Courses pamphlet for course numbers and titles. Do not list courses
that you would not be willing to take. Every effort will be made to
schedule students in preferred courses. If you need to take a given
course, explain why.
All course grades will be permanently recorded at the
University of New Hampshire. By signing a Transcript Release form,
students may have an official transcript sent to their registrars in
the early fall.
DO NOT want your name and phone number released to other program participants seeking a travel companion for the journey to Cambridge.
Are you the dependent of a University System of New Hampshire faculty/staff member?
