international house app

We welcome all students who are internationally-minded to apply to
be international house leaders. UMSL is an equal opportunity
Please type or print in black or blue ink.
Deadline: Friday, April 8 at 5pm
Personal Information
First Name: _________________________________ Last Name: ________________________________
University ID#____________________
Address: ______________________________________________________________________
Cell Phone: ______________________________UMSL Email Address:[email protected]
Eligibility Information
Current class level:
Freshman (29hrs or less)
Sophomore (30-59 hrs)
Junior (60-89hrs) Senior (90 or more) Grad
Major: _________________________ Minor: ____________________
Cumulative GPA*: ____________
Do you currently reside on-campus?
Graduation date: __________
Fall 2015 GPA: ______________
If yes, where and how long have you lived there? __________________________________________
*If your cumulative GPA is below the required 2.5 please explain to us (no less than one page) the
reason for this and some steps that you will be taking to elevate and maintain a 2.5 GPA if you are
Campus and Extracurricular Involvement
Please list any out-of-class activities that you are involved in, including student organizations and jobs on
and off campus.
Position Held
Are you currently employed?
Yes No if “yes” how many hours/week do you work? _____
Judicial History
The International House Leader serves as a role model to other students. Hence, if you are offered an International
House Leader position and accept it, you will be required to authorize UMSL to review your personal information
relevant to this position.
I _____________________________ hereby waive my right under the Family Education Rights and Privacy
Act of 1974 (FERPA), as amended, to inspect or review any: letters of recommendations/statement and
other information that is relevant to this position that is submitted by an UMSL Res. Life member or staff
and/or outside sources.
I certify that this waiver is given voluntarily by me.
Name: ___________________________________ Signature: ________________________ Date:_______________
Have you been found responsible or in violation of any University policy or have you been documented
for any housing violation at UMSL or another institution?
If “yes” please attach a statement explaining the situation.
Getting to Know You
Please type your responses and submit them along with this application. Write a response to Question 1
and then choose one of the questions for Question #2. (You will submit two responses total).
Question 1
Respond with a 500 word statement.
What does diversity on campus mean to you and what unique qualifications would you bring to this
position in supporting diversity on campus?
Question 2
Choose one of the following questions and write a 250-500 word response.
a) One of your i-House leaders has conflicting opinions to you about a program; the source of this
conflict is based upon differing cultural values. What do you do to resolve this conflict?
b) You are working your walk in hours, every day you see the same student come in. When you talk
to this student, you learn that he/she is experiencing culture shock (not meeting other people,
has not eaten in days, unusual sleep schedule, not in class). What do you do?
c) What are the roles of a student’s individual cultural community and a support network of peers
from different backgrounds in the student’s success at university? Is there a point where one or
both of these groups can hinder a student’s success?
Submit at least two references. Your references may include faculty members, academic advisors,
current or former employers, coaches, administrators, high school counselors, teachers, or elected
organization leaders. Your references can either fill out the attached reference form or write a letter.
Ask your references to send their forms/letters directly to Areis Lurry or Rebecca Kehe.
It is your responsibility to ensure that the completed reference forms arrive on time. Please list your
references below.
1) __________________________________________________________________________________
2) __________________________________________________________________________________
Deadline: Friday, April 8 at 5pm
Return your completed application and sign up for an interview time at the
Office of International Student & Scholar Services, 261 MSC, Attn: Rebecca Kehe
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