SUMMER SCHOOL APPLICATION FORM PERSONAL DETAILS Title (Mr/Mrs/Ms/Dr etc) Name (As it appears on your passport) Mailing Address: City, State, Zip Tel (home): Tel (mobile): Email: Secondary Email: Date of Birth: Gender Country(ies) of Citizenship Do you have any medical conditions the Institute should know about? Please list all post-secondary institutions and dates attended, including your current college/university: (Dates, Institution, Major) Have you participated in any study abroad programs in the past? If yes, please list. Have you visited Turkey for study or touristic purposes in the past? Please list any relevant courses that you have attended e.g. Workshops, Conferences (with dates) Please explain how would this summer course help you achieve your educational goals: Please explain your interest in Ottoman language and history and future plans: References (Name, Institution, Position, Email): ADDITIONAL INFORMATION I hereby certify that the statements and information in this application form are true and correct to the best of my knowledge and belief. Upon acceptance to the Ottoman Culture and History Summer School, I also accept to pay a non refundable registration fee of $50 to Istanbul Academy of Sciences Foundation in advance. Signed: Date: Email scanned application form, an official transcript and a reference letter to: bilgi@ibav.org CLOSING DATE FOR APPLICATIONS NOT LATER THAN 21 JUNE 2013 Upon acceptance original documents must be submitted to the following address until the beginning of the summer school in order to complete registration. Istanbul Bilimler Akademisi Vakfı Büyükdere Cad. Raşit Rıza Sok. Ahmet Esin İş Merkezi, No: 4, Kat: 4 Mecidiyeköy, Şişli, İstanbul-TURKEY