APPLICATION FORM FOR OUTBOUND
EXCHANGE AND STUDY ABROAD STUDENTS
SOH JTA Program 2015
INFORMATION FOR APPLICANTS
This application form is for School of Humanities undergraduate students of
the Ateneo de Manila University. Please print this out on A4 paper; feel free
to add additional sheets if necessary. Please answer all questions and submit
this with all other requirements (see “SOH JTA Program 2015 Required
Documents”) on or before the deadline; incomplete applications will not be
processed.
Please attach a passportsize photo here.
APPLICATION DEADLINE: Monday, 11 February 2013
INFORMATION – You may fill in the form fields using Microsoft Word, or you may handwrite the information using print
letters.
ADMU ID number:
Surname (as it appears on your passport):
Given name/s (as it appears on your passport):
Middle name:
Address in Manila Number and Street:
Subdivision, Barangay:
Postal Code, City, Province:
Permanent Address - Number and Street:
Subdivision, Barangay:
Postal Code, City, Province:
Male
Female
Date of birth (mm/dd/yyyy):
Gender:
Telephone number:
Cellphone number:
Email address (must be an address you check frequently):
Year and course (I.S. majors: include concentrations):
Second major, if any:
Minor programs, if any:
Cumulative QPI at the time of application:
Yes
No
Are you an OAA scholar?
If so, please indicate the amount of your scholarship:
STATEMENT OF PURPOSE – In 300 words or less, please describe why you wish to join the SOH Junior Term
Abroad Program. You may attach a separate sheet if necessary.
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PREFERRED JTA SCHEMES – Kindly indicate the JTA schemes for which you wish to be considered. You may
select more than one; please check all that apply.
Yes, I am
interested.
Fee-Paying Scheme
Under the Fee-Paying Scheme, you pay the full tuition of the destination
university abroad. This is usually the most expensive scheme, but there tend to
be more available slots per institution. Some institutions only offer a Fee-Paying
Scheme.
Tuition-Waiver/Student Exchange Scheme
Under the Tuition-Waiver Scheme, you do not need to pay the full tuition of the
destination university. Instead, you need to participate in at least one JTA
Accelerated Semester, for which you will pay the equivalent of a one semester
full load, plus any overload fees. Students who opt not to participate in a JTA
Accelerated Semester but who wish to participate in the Tuition-Waiver scheme
will instead be required to pay an ISEP (International Student Exchange
Program) Fee to cover one semester’s tuition of an exchange student coming to
Ateneo. There are limited slots per institution that offers the Tuition-Waiver
scheme, but Ateneo has dozens of partner institutions that offer this scheme.
ASEAN University Network Credit Transfer Scheme (AUN-CTS)
Under the ASEAN University Network (AUN) Credit Transfer Scheme,
students are given a partial grant by Ateneo to study at one of the top
universities in an ASEAN country. The final decision regarding your acceptance
is made by the partner institution to which you have applied, not by Ateneo.
Application is competitive among students from all over ASEAN competing for
slots at each university. As a result, being accepted into the JTA program does
not guarantee that you will be accepted by the AUN university of your choice.
ASEAN International Mobility for Students (AIMS) Programme
Under the AIMS Programme, students may apply to a program offered by
another university that is also part of the AIMS network, a network that includes
universities from seven countries: the Philippines, Thailand, Malaysia,
Indonesia, Brunei Darussalam, Vietnam, and Japan. Successful applicants have
the opportunity to be considered for a scholarship grant offered by the Philippine
Commissiono on Higher Education that covers airfare and living expenses.
Application for the scholarship is competitive among students from all over Asia
competing for slots at each university. As a result, being accepted into the JTA
program does not guarantee that you will be accepted by the AIMS university of
your choice, nor does it guarantee that you will be given an AIMS scholarship.
Temasek Foundation LEaRN Programme
The Temasek Foundation in Singapore, through its Leadership Enrichment and
Regional Networking (LEaRN) Programme, extends grants for students from
across Asia to study at a university in Singapore (National University of
Singapore, Singapore Management University, or Nanyang Technological
University). Application is competitive, and students are chosen by the Temasek
Foundation based on their leadership or community service record, as well as
their academic achievement. Apart from their academic study, successful
applicants also participate in other activities in Singapore organized by the
Temasek Foundation. The School of Humanities has a screening process to
select its nominees for the programme, but the final decision rests with the
destination universities in Singapore. As a result, being accepted into the JTA
program does not guarantee that you will be accepted into the Temasek
Foundation LEaRN Programme or into the TF LEaRN university to which you
have been nominated.
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No, I am not
interested.
Casa Bayanihan Alternative JTA Scheme
Under this program, the student does not go abroad for her/his JTA term.
Instead, she/he lives with and attends classes with a community of foreign
students from the University of San Francisco undergoing their Casa Bayanihan
experience in the Philippines. Casa Bayanihan is an immersion program that has
four pillars: accompaniment (accompanying the urban poor who live in select
praxis sites which are visited regularly), academics, community (living in
simple community life with other Casa Bayanihan participants), and spirituality
(prayer and spiritual direction). Partial grants are available for this program.
FINANCIAL CONSIDERATIONS – The SOH JTA Program does not award JTA scholarships to students other than
those indicated above. However, a few destination universities do offer a limited number of scholarships/grants on a
competitive basis. If you wish to be considered for these programs that offer scholarships/grants, please describe your
financial situation below.
EDUCATIONAL BACKGROUND
Name of Institution
Academic Years Attended
Awards/Honors Received
Elementary
Education
Secondary
Education
Tertiary
Education
CITIZENSHIP
Citizenship:
Other citizenship/s:
(passport to be used):
(for holders of dual/multiple
citizenship):
City and country of
birth:
Mother tongue/1st language:
KNOWLEDGE OF LANGUAGES OTHER THAN YOUR FIRST LANGUAGE
Language:
Basic
Intermediate
College-level
Near-native
Basic
Intermediate
College-level
Near-native
Reading:
Writing:
Speaking:
Language:
3
Reading:
Writing:
Speaking:
Language:
Basic
Intermediate
College-level
Near-native
Basic
Intermediate
College-level
Near-native
Reading:
Writing:
Speaking:
Language:
Reading:
Writing:
Speaking:
TRAVEL HISTORY
Have you ever traveled to or lived in countries other than the Philippines?
Country
Purpose
Approximate dates of visit
INDEPENDENT LIVING
Do you or have you ever lived independently from your parents/primary guardians for an extended period of time (one
month or more)? If so, kindly describe the context in which you have.
HEALTH AND SPECIAL NEEDS
Do you have any health condition that could prevent a regular schedule of work and study? Please explain.
Do you have any disabilities or disorders (e.g., physical disabilities, learning disabilities, psychological disorders) or similar
conditions that may require special academic accommodations, assistance, or monitoring? Please explain.
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CURRENT IPS
Please fill in the catalog numbers & course titles (abbreviations are fine) of the courses that you are scheduled to take
according to your IPS as it currently stands.
Second year, 1st semester
Second year, 2nd semester
Third year, Summer Semester
Third year, 1st semester
Third year, 2nd semester
Fourth year, Summer Semester
Fourth year, 1st semester
Fourth year, 2nd semester
POTENTIAL MAJOR CHANGES TO YOUR IPS – If you anticipate that you will be making changes to your IPS
because you plan to shift to a different major/concentration, or because you plan to take a minor or specialization, please
explain below.
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Your signature constitutes a pledge that the written responses to the questions in this application
are accurate and entirely your own work.
_____________________________
Applicant’s Signature
_____________
Date
I hereby endorse the application of ______________________________ to the School of Humanities Junior Term
Abroad Program 2015.
_________________________________
Name and Signature of the Department Chair
_____________
Date
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