2013 Application
IMPAQT Mission
The purpose of IMPAQT is to develop strategies and initiatives to best leverage the relationship
between the two campuses toward enhancing student life and the student experience on
both. IMPAQT's work is year-round, and includes activities which:
1. Raise awareness on the CMU-Pittsburgh (CMU-P) about student life on the CMU-Qatar
(CMU-Q) campus
2. Develop mutually-supportive relationships between CMU-P students and relevant
organizations and their counterparts on the CMU-Q campus
3. Ensure that regular, sustained communication mechanisms exist between students on
the two campuses enhance the experiences of CMU-Q students who visit the CMU-P
campus
4. Serve as ambassadors for increasing awareness of the global Carnegie Mellon
community and opportunities fro cross campus involvement on the Pittsburgh campus
Application Instructions
Save your application as lastname-application.[doc/pdf].
Please submit your application to IMPAQT-cmu@andrew.cmu.edu by 5pm on November 7,
2012.
Upon review you will receive an email confirmation that we have received your application.
If you have any questions regarding the application process, email IMPAQT-cmu@
andrew.cmu.edu.
Financial Contribution
The cost of the trip, which covers airfare, hotel accommodation, meals, activities, visa fees and
in-country transport, is $400. If the trip's cost is a barrier for you, we encourage you to still
apply for the IMPAQT program. Assistance is available to those with demonstrated need. The
Office of the Dean of Student Affairs is committed to selecting students for the IMPAQT
program regardless of their financial situation. IMPAQT members will review your IMPAQT
application. Renee Camerlengo, Assistant Dean of Student Affairs, will review requests for
financial assistance separately. Please direct all financial questions to
reneec@andrew.cmu.edu.
PART I: Personal Information
Name __________________________________________
Year level / Expected Graduation Date __________________________ / ___________
Local Address _________________________________________________________
Local Phone Number __________________________
Email ____________________________
Major(s) / Program ______________________________________________________
I give the Office of the Dean of Student Affairs permission to verify that I am in good academic
standing with at least a 2.25 and am also in good conduct standing.
Signature ____________________________________________
PART II: Your Contribution
Please answer the four questions below in less than a page each.
1.
What is it that interests you about CMU’s campus in Doha, Qatar?
2.
Tell us how you heard about IMPAQT.
3.
How will this experience help you in the future?
4.
As part of the IMPAQT program, members develop and implement projects that bridge
the Pittsburgh and Doha campuses. Please provide a description of your idea, including
its objectives and any financial considerations. The projects should support IMPAQT’s
mission and address one of the following experience/opportunities:
a. Campus Exchange
b. Doha/Pittsburgh Room
c. Or feel free to propose a new initiative
PART III: Supplemental Material
Please submit a résumé or list of extracurricular activities, jobs, and other commitments.
Save this document as lastname-resume. [doc/pdf]
PART IV: Reference
Please include one personal reference. There need not be a letter of recommendation, but this
individual should be prepared to speak upon your behalf, if contacted.
____________________________________________
Name
___________________________
Phone Number
Interviews
Interviews for this experience will take place from November 15, 2012 to November 19, 2012.
Please plan to be available for some period in this time frame.
If you are selected for an interview, we will contact you via email on Monday, November 12,
2012 to set up an appointment.