Global Ambassadors Program (GAP) Application: Fall 2014
CONTACT INFORMATION
__________________________________________ ________________________ _________
Family Name First Name Date of birth: day/month/year Gender
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SAM ID Country of Citizenship
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First Language
_________________________________________ _________________________________
Local Address (street name and number) Email Address
________________________________________________ ________________________________________
City State Zip Code Phone Number
PERSONAL INFORMATION (Please fill out all that applies)
School Classification: _______________ Academic Major: _________________________________________
Languages Spoken (other than English) (1)_______________________ (2) ____________________________
Hobbies: (1)_______________________ (2) _____________________________ (3) ________________________
Other Interests: (1)_________________________(2)________________________(3)_______________________
(activities you enjoy participating in)
Name 3 things you like to do with friends on the weekend:
(1) _____________________________(2)______________________________(3)___________________________
Are you involved with any clubs or extracurricular activities? YES____ NO _____
If yes, please list the clubs and extracurricular activities here:
_____________________________________________________________________________________________
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Why do you want to participate in the GAP Program? _____________________________________________
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Do you have your own transportation? YES___ NO___
If yes, would you be willing to occasionally drive your fellow GAP member to the grocery store or to other shopping areas?
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Are you interested in serving on the GAP leadership team? YES___ NO___
(The GAP leadership team will assist the staff advisors by planning, organizing, and leading events and activities, as well as matching international students with their American buddies.
Being a GAP leader can help you learn many skills you can use in your future career such as leadership/management skills, administrative skills, and even intercultural communication skills! Students who are interested in becoming a GAP leader will receive emails from the advisor for future planning meetings. )
Global Ambassadors Program Code of Conduct Agreement
I, ____________________________ agree that for the duration I am in the Global Ambassadors
Program, I will abide by the guidelines listed below. I further agree that I understand that if these guidelines are not followed, it could result in my expulsion from the program, and being barred from further participation. These are the guidelines I will adhere to:

I will not engage in any activities that are considered illegal by the U.S. or the state of
Texas while in the presence of another GAP member.
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I will not allow my to drive any vehicle, unless they have a valid U.S. Driver’s License.

I will conduct myself appropriately and professionally in all interactions with the students and OIP staff.
I agree to these terms by signing below.
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PRINT NAME
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SIGNATURE
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DATE
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