American Youth Leadership Program – Thailand
Student Application
APPLICATION GUIDELINES:
PLEASE REVIEW CAREFULLY BEFORE COMPLETING APPLICATION
Selection Criteria for Student Participants:
 US citizen
 Montana resident: homeschooled or attending a public or private school in Montana during the 2015-2016 school
year
 Age: at least 15 years old and no older than 17 at the beginning of the exchange (July 3, 2016) AND have at least one
semester of high school left to complete after the exchange
 Demonstrated interest in food security, climate change, and international affairs through coursework or extracurricular activities
 Demonstrated service to the community
 Demonstrated flexibility, maturity, integrity, social skills, and open-mindedness
 Motivation to be a successful cultural exchange participant
Participant Expectations:

January to May 2016: Participate in monthly teleconference, video or in-person meetings with the group to prepare
for the in-country learning experience.

January to June 2016: Complete assigned readings and activities as well as conduct personal research to prepare
yourself for the program to maximize your learning opportunities.

July 3-5, 2016 (approximate dates): Participate in a three-day orientation in Missoula.

July 6-July 30, 2016: Thailand exchange (dates to be confirmed upon purchase of air tickets).

August-December 2016: After you have returned from Thailand and no later than December 31, conduct a
community service project to introduce others to Thailand and what you’ve learned.

Conduct yourself during all program activities as a responsible representative of the United States.

Be flexible, attentive, inquisitive, and enthusiastic during program activities.

Willingness to give informational talks at your high school to help recruit future AYLP participants.
Application Information:
Please email your application, transcripts, and attendance record to kelsey.stamm@umontana.edu in one email. Do not
include evaluations. Evaluations are to be emailed by the teachers. Partial application packages will not be accepted.
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A copy of your transcript.
A copy of your high school attendance record.
Two teacher/administrator/counselor evaluations, emailed from the evaluators – not from the student applicant.
Please write the names of your evaluators below. A copy of the evaluation is located at the end of this application.
The student evaluation form can also be found on our website.
Evaluator One Name:
Evaluator Two Name:
4TH FLOOR MANSFIELD LIBRARY | UNIVERSITY OF MONTANA | MISSOULA, MT | 59801| (T) 406.243.2988 | (F) 406.243.2181
Attach additional pages as necessary
This application is available at no charge and can be duplicated
American Youth Leadership Program – Thailand
Student Application
Application
Full name (exactly as it would appear on your passport)
1.
a. First:
b. Middle:
c. Last:
Parent/guardian name(s)
2.
a. Parent/guardian First Name:
Parent/Guardian Last Name:
b. Parent/guardian First Name:
Parent/Guardian Last Name:
3.
4.
5.
6.
Gender:
Date of birth (month/day/year):
City/state of birth:
Citizenship (only U.S. citizens eligible):
7.
Your school information
a. Year in school (freshman, sophomore, junior or senior):
Note that only students with at least ONE semester left of high school remaining in the 2016-2017 school year are
eligible to apply.
b. School name:
c. Expected Month/Year of Graduation:
d. School address:
e. City/state:
f. Zip code:
g. School telephone:
8.
Your contact information
a. Home mailing address:
b. City/state:
c. Zip code:
d. Email:
e. Home Phone (area code first):
f. Cell phone (area code first):
g. Which phone number do you prefer we use to contact you: school, mobile, or home?
h. What time during the day is best to contact you?
i. Do you access email regularly?
i. If “no,” would you commit to accessing email on a daily basis if selected for the program?
4TH FLOOR MANSFIELD LIBRARY | UNIVERSITY OF MONTANA | MISSOULA, MT | 59801| (T) 406.243.2988 | (F) 406.243.2181
Attach additional pages as necessary.
This application is available at no charge and can be duplicated.
2
American Youth Leadership Program – Thailand
Student Application
9.
Please describe any work experience you have had. For each position held, detail the time frame you worked at
the job (month/year to month/year), number of hours worked per week, your tasks/responsibilities, and whether the
work was primarily done during school breaks or the school year.
10. Please describe your volunteer experience, past and present. Please be detailed, including the type of volunteer
activity, the estimated amount of time spent in each activity, and any positions of responsibility. Please be sure to list any
clubs/organizations you currently belong to or have belonged to during your high school career.
11. Introduce yourself. What is most important for program leaders and your Thai hosts to know about you?
12. Medical, physical, dietary, or other personal considerations. Please describe any pre-existing medical conditions,
including any prescription medication you may be taking, or any dietary or personal considerations. Please be sure to
specifically list allergies and degree of concern and treatment. This will not affect candidate selection, but will enable us
to make any necessary accommodations. Please note that the State Department and the University of Montana
encourage participation by students with disabilities and have an established history of accommodating participant needs.
13. If you were to choose a book that best represents who you are, what would it be and why?
14. Describe your family’s culture, such as history, background, the work your parents/guardians do, and how
this has helped to shape who you are.
15. Explain why you would like to join a team of students and teachers traveling to Thailand.
16. If you were selected to be part of this program, what kind of special skills or qualities would you add to the
group (such as specific leadership or communication skills, etc.)?
4TH FLOOR MANSFIELD LIBRARY | UNIVERSITY OF MONTANA | MISSOULA, MT | 59801| (T) 406.243.2988 | (F) 406.243.2181
Attach additional pages as necessary.
This application is available at no charge and can be duplicated.
3
American Youth Leadership Program – Thailand
Student Application
17. Please list any prior travel experience outside the U.S. (list cities/countries visited, dates of travel, and purpose of
visit). As one of the goals of this program is to expose participants to international cultures, preference is generally given
to those who have not traveled extensively overseas. However, international travel experience does not preclude you
from being chosen, as we look at your entire application package.
18. Please describe any languages other than English that you have studied or speak (note the language, number
of years studied, and whether you have used the language in its native culture).
19. If selected, you would travel in a group of 20 high school students, two teachers, and AYLP staff. How do
you think you would feel about this, and how would you manage any needs for personal time?
Signature _________________________
(Typed signatures are acceptable)
Date _____________________
Applications are due November 8, 2015. Application, transcripts, and attendance record must be sent electronically to Kelsey
Stamm (kelsey.stamm@umontana.edu) in one email. You will receive a confirmation email following submission. If you have
not received a confirmation email from the Mansfield Center within two days of email submission, please call Kelsey: 406-2432838. If there is a reason that email submission is not possible, please contact Kelsey.
Selection Process
The selection panel consists of six people: two members of the Mansfield Center staff, one member of the education
community, one former student participant, and the two selected Adult Participants. The panel will invite an expected 40
student applicants to a second application round by November 16, based on the selection criteria listed above. The second
application round consists of a supplementary written application and an oral interview via Skype. Final results will be
announced no later than December 18, 2015.
A candidate will be considered ineligible if s/he has previously traveled outside the United States on any State Departmentfunded program within the past three years or if s/he has accepted a scholarship for an impending US government-funded
exchange program. Should an applicant be accepted for more than one State Department-funded youth program in this
timeframe, s/he must choose between the programs and select only one program in which to participate.
The Mansfield Center of The University of Montana does not discriminate on the basis of race, color, sex, religion, national
origin, age, disability, or veteran status in its programs and activities.
4TH FLOOR MANSFIELD LIBRARY | UNIVERSITY OF MONTANA | MISSOULA, MT | 59801| (T) 406.243.2988 | (F) 406.243.2181
Attach additional pages as necessary.
This application is available at no charge and can be duplicated.
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