Competitive College Club Application

Form
(CCC 2016 EducationUSA Center in
Stip)
I.
Personal information
Applicants first name, surname
Applicants email address
Mailing address
Date of birth:
Citizenship:
Contact number of an applicant
(cell-phone/home)
Full name, contact number of
applicants parent/guardian 1
Email of a parent/guardian 1
Full name, contact number of a
parent/guardian 2
Email of a parent/guardian 1
II. Plans for study in the
U.S.
Field of study
Progress in application
process:

Will you apply for financial

aid offered by U.S
universities?
Do you have any
personal/family funds to
cover the cost of your
education in the U.S.?

Just starting
Choosing/have chosen U.S.
universities to which Id like
to apply
Taking/have taken entrance
exams(SAT, TOEFL etc)

Yes
No

Yes
No
Some funds, but only
for: Tuition/fees; housing/food
U.S. Universities: List colleges/universities to which you will
apply (if you know already)
1.
2.

3.
Do you have relatives in the
U.S.?
Have you ever applied for a
U.S. visa?

Yes
No
Yes
No

III. School information

Current Educational Institution
Type of institution
Public
Private
Current Grade/Year
GPA out of 5
Graduation date
The class specialization (check
Mathematics
in more than one box if needed)
Physics
Computer Science
Biology
Chemistry
English language
German language
World History
Geography
Arts
Other
IV. Educational excellence (add extra fields, if
needed)
If your school provides rating of students in the class/among the
students of the same grade, please fill in the rating scale (add
extra fields, if needed)
Rating:
Score (scale 1-5) :
Subject:
Rating:
Score (scale 1-5) :
Subject:
If participated in any competitions, please fill in the competition
participation table (add extra space if needed)
Participation
School Competition
in
Name of competition:
Subject:

Award:
Period:
Interschool (city) competition
Name of competition:
Subject:
Award:
Period:
Regional competition
Name of competition:
Subject:
Award:
Period:
National competition
Name of competition:
Subject:
Award:
Period:
International competition
Name of competition:
Subject:
Award:
Period:
V. Academic Honors/Awards/Scholarships/
Exchange Programs
Please list any academic honors, scholarships received, or U.S.
government students exchange programs in which you have
participated:
1.
2.
3.
4.
VI. Extracurricular activities (add extra fields, if
needed)
Sports
Type of sport:
Period:
Musical instruments
Type of instrument:
Period:
Visual arts
Kind of visual arts:
Period:
Performing arts
Type of performing arts:
Period:

VII. Community service (add extra fields if needed)

Type of community service:
Institution:
Period:
Type of community service:
Period:
Type of community service:
Period:
VII. The purpose of this exercise is to:

a) help you determine and articulate what you believe make you the unique
from the other applicants
b) help you identify your areas of interest and strengths so that you are
prepared to begin researching undergraduate degree programs

Write a short essay in English answering the

questions:

Why are you interested in Competitive College

Club? What makes you a good candidate for this

Signature
I certify that the information in this form is accurate to the best of my knowledge
Printed Name:

Signature

Date
____________________________
_______________________

__________________

club and for U.S. higher education?