Jacksonville State University
700 Pelham Road North
Jacksonville, Alabama 36265-1602
Office of the Director
International House Program (256) 782-5303
International Programs & Services (256) 782-5674
Fax (256) 782-8057
Website Address: www.jsu.edu/depart/ihop
Dear Scholarship Applicant:
Your inquiry of recent date, in which you have requested information concerning the
International House Program Scholarship, has been received.
I am sending the following for your information and action:
(a) International House Program Scholarship application form. Please execute this, front
and back, and attach a 500 word autobiography, written by you in English, and a small
photograph of yourself and one of your family. This should be returned to me as soon as
possible.
(b) Three recommendation forms. You are asked to get people who have known you for
a long time to execute these. The forms should be returned directly to me. They should
not be sent back to you. One recommendation form should be executed by someone who
has known your family for a long time, one by a community leader, and one by someone
who knows about your school attendance and achievements.
(c) Details of the International House Program Scholarship.
If you are interested, may I suggest that you execute these at once, and return them to me.
This is not a scholarship offer, but an opportunity for you to file an application. We have
many more applications than we have scholarships to offer. Your scholarship application
will not be acknowledged. Only those applicants who are being considered for a
scholarship award will be contacted by me. The deadline for receiving completed
applications for each academic year is January 31.
Sincerely,
John J. Ketterer, Ed.D.
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
International House Program
Jacksonville State University
Jacksonville, Alabama 36265-1602
USA
Details of the International House Program Scholarship
The International House Program generally provides:
1)
2)
3)
4)
5)
6)
7)
8)
9)
Tuition for Fall and Spring academic semesters, beginning in late August
and completing at the end of April.
A room at the International House, to be shared with an American student
for the two semesters as listed.
Meals provided in accordance with Jacksonville State University’s food
service policies, in effect during these two semesters. Scholarship recipient
must provide their own meals during holiday periods.
An incidental expense allowance of $286.00 for the year; payable at $71.50
each eight-week period during these two semesters.
An allowance of $50.00 to help pay for cost of books is available in late
August only.
Sickness and accident insurance for twelve months (August through August
of the following year). This insurance has limitations and the scholarship
recipient must pay for medicine in advance and will be reimbursed, in most
cases, by filing out a claim form.
This is a one academic year scholarship for undergraduates. (ages: 18-23)
Some scholarships are renewed for a second academic year, however, no
student receives an International House Scholarship for more than two
academic years.
Married students are not eligible for an International House Program
Scholarship. In the event a student gets married while on an International
House Program Scholarship, the scholarship is terminated immediately.
Other pertinent information concerning the International House Program and
Jacksonville State University:
1)
2)
3)
4)
Scholarship recipient will need funds for transportation to the United States
and for return trip to native country.
Scholarship allowance for incidental expenses is not adequate to take care of
all personal needs.
I must remind you that a J-1 student cannot work. There is no work on
campus for a foreign student, and no other financial aid, except that offered
by the International House Program.
Book allowance is not adequate to buy books. Books and supplies will cost
approximately $500.00 per semester.
International House Program
Jacksonville State University
Jacksonville, Alabama 36265-1602
USA
Details of the International House Program Scholarship (continued)
5)
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Scholarship recipients will be expected to spend approximately ten hours per
week in forums, seminars, social events, and community groups as a
condition of the scholarship.
Scholarship recipients are expected to have a sufficient knowledge of English
to successfully pursue a full academic load, as all courses, except foreign
languages are taught in English.
This is a Department of State approved Cultural Exchange Program.
Scholarship recipients will come to the United States on a “J-1” visa. At the
conclusion of the scholarship, a student may be required to return to his or
her native country.
For further information and/or application forms for an International House
Program Scholarship, contact: Dr. John J. Ketterer, Director, International
House Program, Jacksonville State University, 700 Pelham Rd. North,
Jacksonville, Alabama, 36265, USA.
International Application: Page 1/5
Date: ___
/
Month
___ /
Day
2004
Website Address: www.jsu.edu/depart/ihop
International House Program
Jacksonville State University
Jacksonville, Alabama 36265-1602
USA
International House Scholarship Application
Please answer the following information and then either e-mail, fax or mail the
information to the International House. If you are planning on e-mailing this
application, resave document in .doc format only and send as an attachment (with
“American Student Application” and your full name in the subject heading).
Personal Information:
Name: ________________________
Last
___________________
First
___
Middle Initial
Father’s Name: ________________________ Occupation: ________________________
Mother’s Name: ________________________ Occupation: ________________________
Present Home Address: ______________________________________________________
Home Phone No.:
______
________
Country Code City Code
____________
Phone Number
E-mail Address: __________________________________________
Date of Birth: ______/_____/_______ Place of Birth: _______
Month Day
Year
City
________
State
_________
Country
Country of your Present Citizenship: __________________
Country of which you are a Legal Permanent Resident: __________________
Gender: ____________
What is your native language? __________________
International Application Page 2/5
Name: ______________________________
What other languages do you speak?
______________________________________________________________________________
______________________________________________________________________________
What other languages do you read?
______________________________________________________________________________
How many years have you studied English? _____ years
How do you consider your ability to speak, write, and understand English?
(Place an X next to one of the choices.)
_____
_____
_____
_____
_____
Outstanding
Excellent
Above Average
Average
Below Average
How many brothers do you have? _____
List their ages: (example: 13, 24, 6):
______________________________________________________________________________
How many sisters do you have? _____
List their ages: (example: 13, 24, 6):
______________________________________________________________________________
Do you have any physical handicaps:
(Place an X next to either “yes” or “no” for each choice.)
Eyes:
_____ Yes
OR
_____ No
Hearing:
Speech:
Extremities:
_____ Yes
_____ Yes
_____ Yes
OR
OR
OR
_____ No
_____ No
_____ No
If you answered yes to any of the above handicaps, please give details below:
______________________________________________________________________________
______________________________________________________________________________
Have you ever had any serious illnesses in the past five years? ____Yes or ____No
If you answered yes, please give details below:
______________________________________________________________________________
______________________________________________________________________________
International Application Page 3/5
Name: ______________________________
Your Interests:
Hobbies:
______________________________________________________________________________
______________________________________________________________________________
If you are musically talented - which instrument can you play?
______________________________________________________________________________
Your Education Background:
What is your major field of academic interest?
______________________________________________________________________________
What is your "second" field of academic interest?
______________________________________________________________________________
Schools/Colleges/Universities Attended:
Other Colleges/Universities Attended:
Name of School
Location of School
Dates Attended:
Graduated Y or N?
____________________
__________________
_______ to _______
________
____________________
__________________
_______ to _______
________
____________________
__________________
_______ to _______
________
International Application Page 4/5
Name: ______________________________
Your Education Background (continued):
List any academic honors:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Where have you lived?
List states (in the United States) that you have resided (for more than 6 months):
______________________________________________________________________________
______________________________________________________________________________
List foreign countries you have resided:
______________________________________________________________________________
______________________________________________________________________________
List foreign countries you have visited:
______________________________________________________________________________
______________________________________________________________________________
** Attach a recent photograph of yourself, also, a group photograph of your family.
*** Attach a 500 word statement (typed or in your own handwriting in English) which
includes an autobiography of your life including family background, plans for the future,
and your general philosophy of life.
Other Pertinent Information:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
International Application Page 5/5
Name: _____________________________
One last thing.
Signed (typed): ________________________
Date: ___
/ ___ / 20 ___
Month Day
Year
If you have any additional documents you would like us to have, please either: mail, fax or
e-mail (.pdf or .doc form only). Make sure that you have your name clearly on the items
sent. They will not be returned so be sure to only send copies.
Mail:
Director, International House Program
International House – Jacksonville State University
Attn: International Scholarship Application
700 Pelham Rd., North
Jacksonville, Alabama 36265
USA
E-mail:
jkettere@jsu.edu
Fax:
1-256-782-8057 (Check international dialing codes before calling the United
States.)