The University of St. Thomas

Reaching Excellence in Academics and Leadership (REAL) Program and Summer Academy

Program dates are: Sunday, June 28, 2009 to Saturday, August 8, 2009

If you have any questions regarding this application, please contact Multicultural Student Services at 651.962.6460 or multicultural@stthomas.edu

 

Participant Application (all fields are required)

I am applying for and meet the requirements for the REAL Program (see Program Requirements and Information)

I am applying for and meet the requirements for Summer Academy (see Program Requirements and Information)

I am applying for and meet the requirements for both REAL Program and Summer Academy (see Program Requirements and Information)

Please note you can only be accepted for one program

Full Name :
Preferred Name :
Email :
Street Address :
City :
State :
Zip :
Home Phone :
Social Security # :
Date of Birth (mm/dd/yyyy):
Gender :

MaleFemale

Ethnicity/Race :
Emergency Contact Name :
Relationship :
Emergency Contact's Phone :
Emergency Contact's Address :
Are you a first-generation college student (the first in your family to attend a 4-yr college)? :

YesNo

Are you a transfer student? :

YesNo

During the academic year, do you plan to live on-campus (in a University residence hall)? :

YesNo

Intended major/minor at the University of St. Thomas :
Special Requests/Needs (Use comment section to provide specific information if needed) :

None

Disability (learning/other)

ESL

Dietary Restriction

Allergies

Other (seizure disorder,mental health concerns,asthma,diabetes etc.)

A ONE - PAGE STATEMENT describing why you hope to participate in the REAL Program, what you hope to gain from the experience and what unique skills and commitment you will offer. (at least 300 words) :

 

Agreements

Please check box to confirm your agreement:

 I have been accepted and have confirmed as a full-time, degree-seeking student at the University of St. Thomas for fall semester 2009. 
I understand that if I am accepted into the 2009 REAL Program or Summer Academy, I will complete my enrollment process during the University of St. Thomas Summer Orientation and Registration Session in July 2009
I authorize Multicultural Student Services staff to review my Admission and Financial Aid records (i.e. ACT score, high school transcript, FAFSA, etc.). This information will be kept confidential and will be used only for placement in REAL Program and/or Summer Academy
I agree to live in the University of St. Thomas residence halls for the duration of the six-week program (June 28-August 8, 2009)
I am commited to full participation in the REAL Program and/or Summer Academy and therefore agree not to hold any other obligations during the six-week program
I agree to adhere to the university of St. Thomas' policies and procedures


Don't forget to submit two reference forms completed by a teacher, coach, supervisor, club sponsor or other professional contact. Click here to print the Participant Reference Form.

Checklist

Please confirm that you have completed:
  • This completed Participant Application
  • Two completed Participant Reference forms
  • A One-Page Statement (space provided in the form above) describing why you hope to participate in the REAL Program and what you hope to gain from the experience and what unique skills and commitment you will offer.

The REAL Program and Summer Academy application deadline is 5/1/09. You will be notified through email by 5/8/09 if you are selected for the program