SAMPLE COURSE APPLICATION FORM * PAGE 1

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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:
[email protected]
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
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