Study Abroad and Global Learning Student Representative Application Submit your completed application to: Western Kentucky University Office of Study Abroad and Global Learning Grise Hall 128, 1906 College Heights Blvd. # 11064, Bowling Green, KY 42101 Phone: (270) 745-5334 • Fax: (270) 745-2883 • E-mail: study.abroad@wku.edu	SR
PERSONAL INFORMATION
Full Name: WKU Student ID: Email Address: Cell Number: Current Address: Residence Hall (if applicable): City, State, and Zip: Hometown: Status (please check one): Gatton Academy Freshman Sophomore Junior Senior Graduate Major: Minor: GPA: Anticipated Graduation: Study Abroad Program(s) and Term(s): (Example: Czech Republic with Dr. Murphy Summer 2010, Semester at Sea Fall 2011, etc.)
CURRENT EMPLOYMENT (IF APPLICABLE)
Employer: Position: Location (please check one): On campus Off campus Number of Hours Working Per Week: Employment Start Date: Supervisor's Name/Phone#: Describe your position duties:
RELEVANT INTEREST & EXPERIENCE TRACK PREFERENCE
Check the boxes to indicate any area(s) in which have experience, as well as any area(s) in which you are interested: Experience Interest Public Speaking Graphic Design Web Design Communications Skills (Written/Oral) Advising Working Independently Computer Skills (Word/Excel/PowerPoint/Outlook) Other:	Please rank your preference of student representative tracks: 1. 2. 3. Note that there are three track options for placement within the Study Abroad Student Representative program: Exchange Student Mentor – Exchange veterans who will enhance incoming exchange students’ transition and student experience. Peer Advisor – Advisors to prospective study abroad students. May assist with program selection, pre-departure process, etc. Ambassador – Campus representatives of study abroad. May assist with outreach, recruitment, publicity, public relations, etc. More detailed descriptions of the track options can be found at www.wku.edu/studyabroad/...
REFERENCES
Please provide two references. Study abroad, academic and employment references are preferred. Name: Position or Title: Relationship: Length of Relationship: Phone Number: Email Address: Name: Position or Title: Relationship: Length of Relationship: Phone Number: Email Address:
SUPPLEMENTAL MATERIALS
Short Essays Please answer in no more than 200 words per question. Type and attach your responses to this application form. 1. What experience and/or skills do you have that equip you to be an effective Study Abroad Student Representative? 2. Reflect on your own study abroad experience. What was the most rewarding aspect? What was the most valuable lesson you learned? How did your experience contribute to your academic, professional, and/or personal development? Class/Work Schedule Please attach your “Week at a Glance” to this application form. 1. Upon login at www.topnet.wku.edu, follow this path to locate your weekly class schedule: Student Services > Registration > Student Schedule by Day & Time 2. Print your “Week at a Glance” and mark weekly work commitment (if applicable), as well as your availability for Study Abroad Representative responsibilities.
ACKNOWLEDGEMENT AND SIGNATURE
Electronic Signature: By checking this box you indicate you have read and understand the application process as detailed at www.wku.edu/studyabroad/... Signature Date If the above signatory is under 18 years of age, a parent or legal guardian shall sign below: I, (print name), acknowledge that I have carefully read, agree to and understand the above statements. Date: Signature: Phone: Relationship to above signatory: