NSLI Y 2017-18 Application Sample PDF

National Security Language Initiative for Youth, 2017-18
Application Sample
About the Application Table of Contents and

Deadlines
Application Deadline: October 27, 2016 4 PM U.S. Eastern Standard Time
SECTIONS OF THE APPLICATION

A. About the Application
A. Table of Contents and Deadlines
B. How to Apply
B. Personal Information
C. About You
D. School Information
E. Family Information
F. Certify Your Eligibility
G. International Experience
H. Activities, Awards, and Interests
I. Photos (Upload)
J. Statistical Information
C. Documents
K. Transcripts
L. Terms and Conditions
D. Recommendation and Statement Requests
M. Teacher Recommendation
N. Parent/Legal Guardian Statement
E. Placement Information
O. Program Preferences
P. Personal Preferences
Q. Medical Information
F. Host Family Letter and Short Essays
R. SelfIntroduction to Host Family and Language Instructors
S. Essays
G. Language Experience
T. Knowledge of Languages
U. SelfAssessment of NSLIY Language Preferences
H. Submit Your Application
V. Review and Submit
APPLICATION DEADLINE AND SUBMISSION OF REQUIRED DOCUMENTS

Deadline Tasks due
Online Application Formcompleted by the applicant.
Due Online Terms and Conditions Form signed by applicant and all parents/legal guardians.
Âpplication_DeadlineDate^ Terms and Conditions must be postmarked by this deadline if the applicant is not
able to upload the document online.
Postmarked No Later than

Grade Transcripts: sent by School Registrar or Home School Supervisor.
Âpplication_DeadlineDate^
Parent/legal guardian
Parent/legal guardian
Due Online Teacher recommendation
November 10, 2016 at 4:00 pm EST
Send Grade Transcript documents to:
ATTN: NSLIY File Processing (#1100G)

American Councils for International Education
1828 L St NW Ste 1200
Washington DC 200365136
About the Application How to Apply

Application Deadline: Âpplication_DeadlineDate^
IMPORTANT! Do not use your web browser's back buttonto move between pages within this online form.
This might erase information from your form that cannot be recovered. Useonlythe "Sections" menu on
the left, including the (next) and (previous) arrows to switch to the next and previous sections of the
form.
HOW TO APPLY
Online Application Form:Complete and submit the application form online. All applications and
recommendation forms must be submitted online, except in rare cases in which the applicant can
demonstrate that this requirement presents a significant impediment to applying for a NSLIY scholarship.
Applicants who need to make alternative arrangements for submission of their application must do so by
October 15, 2016. Applicants who need further assistance may contact American Councils at
866.790.2086, ornsliy@americancouncils.org.
Terms and Conditions: Carefully read the Terms and Conditions.This form must be signed by the
applicant and all parents or legal guardians. Upload the completed signature page of the Terms and
Conditions Form to your application. Applicants who do not want to upload the signature page may
mail the final signature page to NSLIY. The form must be postmarked by the application deadline,
October 27, 2016.
Official Grade Transcripts:Request an official copy of your grade transcript be sent by mail to NSLIY from
your high school. Transcripts must include completed courses, grades, and GPA. Transcripts must be
postmarked by the application deadline, October 27, 2016.
Teacher Recommendation:Haveone (1)teacher submit a recommendation using the online form. The
recommendation must be submitted by 4:00 PM Eastern Time on November 10, 2016.
Parent/Guardian Statement::Haveone (1)parent/legal guardian submit a statement online supporting
your application. The statement must be submitted by 4:00 PM Eastern Time on November 10, 2016.
Note: Any technical problems with the application form should be reported by email
tonsliy@americancouncils.org, however, there is no guarantee that NSLIY staff can respond to inquiries on
October 27, 2016. NSLIY strongly encourages that applicantsask any questions and submit their applications
well in advance of the application deadline. The NSLIY program and American Councils for International
Education bear no responsibility for data transmission problems in submitting the application.
When emailingnsliy@americancouncils.org, please use the following subject line convention:Reference

Code, Last Name, First Name: Email Subject
Ex: ABCE1234, Doe, Jane: Question about application
Note: Your reference code is the eightdigit, randomlyassigned code at the top of this page with four letters and
four numbers that identifies your unique application.
HOW TO USE THIS ONLINE FORM

Moving from Section to Section
This online form includes several sections (pages). They are listed in the "Sections" menu that can be found
EITHER in the navigation menu at the left side of each page OR in the dropdown menu at the top of each
page. You may select any section from the menu to jump to that section. You may also press the (next)
and (previous) arrows to switch to the next and previous sections of the form.
Saving Your Work

To save your work at any time, press the "Save Changes" button that can be found at the bottom of any
page. It is a good idea to regularly save your work while completing the form to ensure that none of your work
is lost in the event you lose your Internet connection, your computer is accidentally shut down, etc.
Completing Your Form in Multiple Sessions

It is not necessary to complete your online form in one sitting. To continue later, press the "Save Changes"
button that can be found at the bottom of any page, and then log out of the system. You can then log in at
any time thereafter until the form deadline to complete your form.
Required Fields
A *next to a question indicates a required field. You must provide this information in order to submit your form.
A Note About Word and Character Counts Used in this Online Form
Any minimum or maximum word or character counts specified in the instructions for some questions will be as
indicated by the counter tool used in this form. Please note that this count may not be the same as counts
indicated by Microsoft Word, OpenOffice.org Writer, or other wordprocessing tool.
Submitting Your Form

To submit your online form,you must press the "Submit" buttonon the last page. If you do not press the Submit
button, your form will be considered incomplete and will not be considered for selection. You will not be
allowed to make any changes after you submit it.
Downloading Documents from this Website
The freeAdobe Readeris required to open and view most documents on this website.
Uploading Documents and Photographs to Your Form

You might be asked to upload a document or photograph. In most cases, you may upload only files of the
following types: PDF, JPG/JPEG, PNG, GIF, or TIF/TIFF. You may also be asked not to upload files with a size
greater than 2 MB. Encrypted or passwordprotected files will not be accepted unless "Read Only" capability is
enabled. A number of free online tools are readily available to convert or resize your files.
QUESTIONS?
For information about the NSLIY program, please visitwww.nsliforyouth.org
Contact NSLIY staff during normal business hours, 9:00 A.M.5:00 P.M. U.S. Eastern Time, MondayFriday, at:
Email:nsliy@americancouncils.org
Telephone: 866.790.2086 (toll free in the USA) (+1) 202.833.7522 (outside the USA)
Personal Information About You
ABOUT YOU
1) Legal Name:
As indicated on your birth certificate, passport, or other governmentissued ID
UseEnglishcharacters, only.
Do not useaccent or diacritical marks.
Use proper capitalisation.Do not useall UPPERCASE or all lowercase letters.
If you do not have a "Middle Name," leave that box blank.
Legal First Name Legal Middle Name Legal Last Name
2) Your Preferred Nickname
3) Gender
Female
Male
Other
4) Date of Birth
Use the date picker, or enter in the format Mmm dd, yyyy (e.g., Sep 01, 2000)
Note: Eligible students must have birthdates within the ranges listed below.

Program Duration Eligible Birthdate Range

Summer Birthdate: July 10, 1998 June 10, 2002
Academic Year Birthdate: September 20, 1998 June 30, 2002
PLACE OF BIRTH
5) Country of Birth
Please first tell us the country (including the United States)
Choose
6) City of Birth
7) U.S. State or Possession of Birth

Choose
7) Province/State/Governorate/Region of Birth
If none, enter "None"
PASSPORT AND CITIZENSHIP

8) Do you have a valid U.S. passport?
NSLIY finalists will be expected to have a U.S. passport that is valid forat least six monthsafter their anticipated program end date.
Semifinalists should be prepared to submit passport information byFebruary 28, 2017. (Please note that if you are selected to study in
Russia, your passport must be valid for 18 months after your anticipated return the U.S., and if you are selected to study in India or
China, your parent(s) or legal guardian(s) may also be required to have a valid passport(s) to obtain a visa.) Note that passport
processing time may be lengthy. Semifinalists are strongly encouraged to apply for a passport at the time of semifinalist notification if
they do not have one that meets validity requirements. If selected, be aware that your passport may need to be available for up to 3
months prior to the program start for visa processing.
Yes
No
9) Can you be considered a citizen of any country other than the United States?
Yes
No
9a) If yes, for what country?
Choose
YOUR CONTACT INFORMATION

Mailing Address:
10) Country
U.S. possessions, military, and diplomatic addresses must specify United States as the Mailing Country.
Choose
11) Street Address
12) City
13) U.S. State or Possession

Choose
13) Province/State/Governorate/Region
14) ZIP/Postal Code

Physical Address:
15) Is the physical address of your home different from your mailing address?
Yes
No
If yes, please provide yourphysical addressbelow:
15a) Country
U.S. possessions, military, and diplomatic addresses must specify United States as the Mailing Country.
Choose
15b) Street Address
15c) City
15d) U.S. State or Possession

Choose
15d) Province/State/Governorate/Region
15e) ZIP/Postal Code

Telephone Numbers:
Include area code (for North America), or country and city/mobile codes (outside North America)
Include spaces, hyphens [], and parentheses [()]
16) Primary Telephone Type

Home Mobile
17) Alternate Telephone Type

Home Mobile
18) Other Telephone, if any Whose Telephone is this "Other Telephone?"
19) Primary Email Address Ensure that your email

This will be NSLIY administration's primary method of communicating with you. address is typed in correctly.
It can be a personal or family email address, but it should be an email address that will be Important, timesensitive,
checked often. notifications will be sent to this
email address.
20) Alternate Email Address

Some email messages from NSLIY administration will be sent to both the primary and alternate email addresses.
The alternate email address can be a personal, family, or parent/guardian's email address.
CONGRESSIONAL VOTING DISTRICT

What is your U.S. Congressional District Number?
Include both your State/Territory and District Number.
To find your congressional district, please visithouse.gov/representatives/find
21) State/Territory
Choose
22) District Number or At Large

Select district number for your Congressional district.
Choose "At Large" for states and territories with only one (1) Congressional representative or delegate:
(i.e., Alaska, American Samoa, Delaware, District of Columbia, Guam, Montana, North Dakota, Northern Mariana Islands, Puerto
Rico, South Dakota, U.S. Virgin Islands, Vermont,and Wyoming)
Choose
Personal Information School Information

YOUR HIGH SCHOOL INFORMATION
1) Your Current Grade
9th
10th
11th
12th
2) Your Anticipated Graduation Date
Enter in format "Mmm yyyy". Example: "Jun 2017".
3) School Name If you are homeschooled,

for the "School Name" field,
enter "Home School".
School Address
4) Country If you are homeschooled,
Please first tell us the country (including the U.S.A.) U.S. possessions, military, and diplomatic for the "School Address" field,
addresses must specify U.S.A. as the Mailing Country. enter your home address.
Choose
5) Street Address or PO Box
6) City
7) U.S. State/Possession
Choose
7) Province/State/Governorate/Region
8) ZIP/Postal Code
9) School Website If you are homeschooled,

for "School Web Site", enter the
web site address of your local
school district or "None".
Personal Information Family Information

ABOUT YOUR PARENTS / LEGAL GUARDIANS
1) Please list each and every one of your parents/legal guardians, as applicable:
Anyone listed as a parent or legal guardian in your application must be identified by thesame namein other forms that require the
signature of parents / legal guardians.
a) Legal First Name Legal Last Name
b) Gender
Female
Male
Other
c) Parent Type
Choose
d) Does this person have legal custody of you?

Yes
No
e) Country of Birth
Choose
f) Primary Telephone Type

Home Mobile Work
g) Alternate Telephone Type

Home Mobile Work
h) Other Telephone Type

Home Mobile Work
i) Email Address
Personal, work, or family email address
j) Do you currently live with this parent/legal guardian at thephysicaladdress you input in the previous
section?
Yes
No
(i) If no, please explain:
0 characters counted.Maximum of 255 characters allowed.
(ii) If no, enter your parent's/legal guardian's physical address below.
Country
Please first tell us the country (including the U.S.A.)
Choose
(iii) Street Address
(iv) City
(v) U.S. State/Possession

Choose
(v) Province/State/Governorate/Region
(vi) ZIP/Postal Code
Delete
Add 1 More Add 2 More
ABOUT YOUR SIBLINGS

2) Do you have any siblings or other household members who are also applying for NSLIY this year?
Each applicant is evaluated independently.
Yes
No
2a) If yes, please list each of your siblings:
(i) Legal First Name Legal Last Name
(ii) Gender
Female
Male
Other
Delete
ALTERNATE EMERGENCY CONTACT

3) In the event your parents or legal guardians cannot be contacted, please provide at leastone (1) adult
who does not live with youas your alternate emergency contact person. To ensure that NSLIY staff can
contact this individual promptly in case of an emergency, a phone number and email addressmustbe
provided for this individual. Please only identify an individual for which this information can be provided:
a) Legal First Name Legal Last Name
b) Gender
Female
Male
Other
c) Relationship to You
Choose
d) Primary Telephone Type

Home Mobile Work
e) Alternate Telephone Type

Home Mobile Work
f) Other Telephone Type

Home Mobile Work
g) Email Address
Personal, work, or family email address
Delete
Personal Information Certify Your Eligibility

CERTIFICATION OF ELIGIBILITY
Eligibility requirements of the National Security Language Answering "no" to any of
Initiative for Youth (NSLIY) scholarship for program year 201718. the following questions
indicates that you are not
eligible for the NSLIY 201718
program. Please
contactnsliy@americancouncils.orgif
you have any questions about
the eligibility requirements.
1) I am a U.S. citizen.
True
False
2) I have a grade point average (GPA) or equivalent of 2.5 or higher on a 4.0 scale.
True
False
3) My birth date is between July 10, 1998, and June 10, 2002, if I am applying for a summer program
ORbetween September 20, 1998, and June 30, 2002, if I am applying for an academic year program.
True
False
4) I am currently enrolled in high school at the time I submit this application.
True
False
5) I have read the U.S. Department of State Eligibility Policy for American Outbound Youth Programslocated
here: Eligibility Policy.
True
False
6) I am eligible to apply for the 201718 NSLIY program according to the abovementioned Eligibility Policy.
True
False
7) Certified by:
Enter your full name
Personal Information International Experience

1) Have you previously participated in a NSLIY Program?
Yes
No
If yes, complete questionsa) through d):
a) When did you participate?
2013 Summer
2014 Summer
2015 Summer
2016 Summer
b) What language did you study?
Choose
c) Which organization implemented your program?

Choose
d) Please explain why you feel another NSLIY experience is important or beneficial for you. Please also
describe any efforts you have made to continue studying the language of your last NSLIY
experience.
0 words counted.Maximum of 250 words allowed.
2) Have you previously participated in any other international exchange program(s)?

Yes
No
a) If yes, have you previously participated in any program(s) sponsored by the Bureau of Educational
and Cultural Affairs, U.S. Department of State? (Seehttp://exchanges.state.gov/us)
Yes
No
i) If yes, please provide details on programs sponsored by the Bureau of Educational and Cultural Affairs, U.S.
Department of State:
# ProgramName Ifother,which? StartDate EndDate HostCityandCountry
1 Choose

b) If yes, have you previously participated in any program(s) sponsored by an organization OTHER THAN
the Bureau of Educational and Cultural Affairs, U.S. Department of State?
Yes
No
i) If yes, please provide details on all other programs
# ProgramName StartDate EndDate HostCityandCountry DescribetheProgram
1 Choose

3) Have you otherwise traveled or lived abroad?
Yes
No
a) If yes, please explain:
4) Do you have any relatives or close friends that live in NSLIY host countries?
NSLIY host countries may include China, Estonia, India, Jordan, Moldova, Morocco, Oman, Russia, South Korea, Taiwan, Tajikistan,
and Turkey.
Yes
No

Personal Information Activities, Awards, and Interests
ACTIVITIES, ATHLETICS, AND ORGANIZATIONS
1) List only those activities and organizations in which you have been a frequent There are 10 slots available
participant within the past three years. Include activities such as Scouts, for each section. If you are
volunteer work, religious youth groups, peer tutoring, sports teams, etc. Be sure receiving an error with this
section, please verify that you
to briefly specify any offices you held with those groups, such as club are using the correct date
president, team captain, or other position: format. An example of a
correct date format is 08/2016.
Use your best estimate for
hours per month. If you are
including a seasonal activity,
list the average hours per the
months that you engage in
the activity.
# Activityor Description HoursperMonth StartDate(mm/yyyy) Still Ifno,EndDate
Organization Participating? (mm/yyyy)
1 Yes
No
0 words counted.Maximum of
50 words allowed.
Add 1 More Add 2 More Add 3 More
PAID WORK OR JOBS

2) Please specify the type of work and describe your responsibilities:
# Employment Description HoursperMonth StartDate(mm/yyyy) Still Ifno,EndDate
Title/Position Employed? (mm/yyyy)
1 Yes
No
50 words allowed.
CREATIVE WORK, HOBBIES, AND SPECIAL TRAINING

3) Include activities such as music, dance, drama, performing arts, and foreign languages that you have
pursued to the point of some mastery:
# Name Description HoursperMonth StartDate(mm/yyyy) Still Ifno,EndDate
Participating? (mm/yyyy)
1 Yes
No
50 words allowed.
AWARDS, HONORS, AND SPECIAL RECOGNITION

4) Please briefly describe the award:
# Description AwardDate(mm/yyyy)
1
Personal Information Photos (Upload)

Photos are optional and not considered in the selection process. You may submit your application
without uploading passport or other photos.
UPLOAD ONE PASSPORTTYPE PHOTO

Upload a passportsize photo of yourself.
The photo size should be approximately 2" x 2" (5 cm by 5 cm), and show only your face from the shoulders up.
It is not necessary to purchase an "official" passport photo for this purpose. You may approximate one with
your own camera or use a yearbookstyle photo. Please avoid uploading "selfies" taken with a mobile phone
camera. A number of free online tools are readily available to convert or resize your photo.
1) Upload Passport Photo If you are having difficulty

You will be taken briefly to another screen while your file is validated by this system. uploading a photo and are
Select File... otherwise ready to submit your
application, please submit
your application without
photos.
Photos are not considered
during the selection process. If
you weren't able to upload a
photo and you submitted your
application, you can email
your photo
tonsliy@americancouncils.organd
we can add it to your
application after the
application deadline.
File types allowed: PDF, JPG/JPEG, PNG, GIF, TIF/TIFF
UPLOAD ONE OR TWO PERSONAL PHOTOS

To help introduce yourself to a host family or teachers, please select up to two photographs showing you by
yourself, or with your family and/or friends. Be creative, but please ensure the appropriateness of the
photographs and captions!
You may attach up to two (2) photographs.

Please resize your photos so that [a] neither the width nor the height is greater than 600 pixels, [b] the
resolution is no greater than 300 pixels per inch, and the file size is no greater than 2 MB. A number of free
online tools are readily available to convert or resize your photos.
Be sure to include a brief caption, no more than 100 characters (including spaces), with each photo,
and to identify yourself in the photos.
This might be the first impression your host family or program administrators will have of you keep it clean!
Any photo and/or caption deemed inappropriate by NSLIY, in its sole discretion, may be removed. These
photos are not considered in the selection process.
2) Photos
You will be taken briefly to another screen while your file is validated by this system.
File types allowed: PDF, JPG/JPEG, PNG, GIF, TIF/TIFF
# UploadPhoto CaptionforPhoto
1
Select File...
2
Select File...
Add 1 More
Sample Photo and Caption
This photo was taken while hiking in the New Mexican wilderness with friends I'm on the far left.
Personal Information Statistical Information

Providing this information is voluntary
The information requested here will be used for statistical analysis of NSLIY. It will have no bearing on the
evaluation of your application. It will not be included in the materials reviewed by the selection
committee.
1) How would you describe yourself?
Check all that apply
American Indian or Alaska Native
Asian
Black or African American
Latino/Latina
Native Hawaiian or Other Pacific Islander
White
Other
(a) If other, please explain:
2) What is your household's annual income?

$45,000 or Less
$45,000 to $90,000
$90,000 to $150,000
$150,000 to $250,000
$250,000 or More
3) Do you qualify for theNational School Lunch Program?
Yes
No
4) What type of school do you attend?
Public
Private
Charter
Home
Other
5) How would you classify the area where you live?

Urban
Suburban
Rural
Other
(a) If other, please describe:
6) How did you learn about the NSLIY program?

(Check all that apply)
College/university professor or administrator
Email
Exchange program
Family member or family friend
High school teacher or counselor
Local volunteer
National Society of High School Scholars
Newspaper (school, local, regional, etc.)
NSLIY alumni or participants
Poster or brochure
School club
School presentation
Social media (Facebook, Twitter, Instagram, YouTube, etc.)
STARTALK
Study abroad organization
Website or Internet search
Youth Service America
I am a past applicant
Other
7) Make intercultural learning a family experience! Perhaps your family would consider hosting an
international exchange student. Would your family like to receive information about this unique
opportunity?
Yes
No
Documents Transcripts
Postmark Deadline for Mailed Transcripts: Âpplication_DeadlineDate^
Originals of the following documents must be mailed to American Councils at the address below, with
apostmark date of no later than Âpplication_DeadlineDate^:
ATTN: NSLIY File Processing (#1100G)

1828 L St NW Ste 1200
NSLIY staff are unable to confirm the receipt of transcripts. Applicants will be contacted if materials are
missing.
Document Instructions
Submit this form at your school to request that your official transcripts be sent to NSLIY. Be
Grade mindful that transcript processing time may be lengthy. Transcripts must be postmarked no
Transcript later than October 27.
Request Transcripts should be mailed by the registrar directly to NSLIY at American Councils in a
sealed and unopened envelope.
Home School For homeschooled applicants, ONLY

Transcript Form
Homeschooled applicants must submit the NSLIY Home School Transcript form.
For 9th Graders, ONLY

9th Grade Applicants who are currently enrolled in 9th grade must provide the following two items:
Transcript and
Classes List Official Grade Transcript from your junior high/middle school
Request List of current classes enrolled in at high school
Both these items should be mailed by the registrar directly to NSLIY at American Councils in
a sealed and unopened envelope.
Document Terms and Conditions

INSTRUCTIONS
Each applicant must submit a signed copy of the Terms and ConditionsParticipant Agreement signature
page. The applicant and all parents/legal guardians must carefully read the document and sign the form e
signatures will not be accepted.If selected for participation in NSLIY, students will be expected to comply
with the NSLIY Terms and Conditions. Applicants and their parents/legal guardians should save a copy of the
Terms and Conditions for future reference.
Applicants should upload the scanned copy of the fully signed final page of the form before submitting
his/her NSLIY application.
Step One
1) Download a copy of theNSLIY Participant Agreement Terms and Conditionsdocument using the link
below.
2) Read and sign agreement where indicated on the last page.Both you and all parents/legal
guardiansMUST sign this agreement.
NSLIY Participant Agreement Terms and This agreement must be signed by you and all parents/legal
Conditions guardians.
Step #2
1) Please indicate how you plan to submit your Terms and Conditions:
Upload File Directly in Application
Postal Mail
MAILIN FORM
Postmark Deadline for Mailed Terms and Conditions: Âpplication_DeadlineDate^
2) Please check the box below confirming that you will send the signature page of your Terms and Conditions
Form by postal mailno later than the application deadline of Âpplication_DeadlineDate^. Should an
applicant not be able to upload the form, he/she can mail the completed signature page to the following
address:
ATTN: NSLIY File Processing (#1100TC)
1828 L St NW Ste 1200
I will mail the Terms and Conditions signature page by the application deadline.
UPLOAD TERMS AND CONDITIONS FORM

2) Scan the signature page of the Terms and Conditions document and upload it below. Remember, the
form must be signed by the applicant and all parents/legal guardians Adobe esignatures will not be
accepted.
You will be taken briefly to another screen while your file is validated by this system.
Select File...
File types allowed: DOC/DOCX, PDF, JPG/JPEG, PNG, GIF, TIF/TIFF
Recommendation Request Teacher

Recommendation
Deadline for Teacher to Submit Recommendation: November 10, 2016, 4:00 P.M. U.S.
Eastern Time
Your application must include a recommendation from one of your teachers. It must be submitted using this
website (AIS Forms).
It is your responsibility to ensure that the letter of recommendation is received by NSLIY.
If you or your teacher have

trouble with the online teacher
recommendation, please
contactnsliy@americancouncils.org.
BEFORE YOU REQUEST A RECOMMENDATION

Talk with your teacherto determine if he or she is willing and able to provide this recommendation for
you.
Instructions for Download this instructions document and give it to your teacher. It explains how to
Your Teacher submit the recommendation online.
Tell your teacher to expect an emailfromais_accounts@americancouncils.org. Suggest that your teacher

add this address to his or her "safe" or "contacts" list so that the message does not go into a spam or junk
mail box. If he or she does not receive this email message, suggest that he or she check the spam or junk
mail box before contacting NSLIY.
If your teacher gives you a "K12" address, you may want to ask him or her to provide an alternative email
address to receive the NSLIY Teacher Recommendation request. "K12" addresses often block email
messages from unknown sources, such as this application system.
WHEN YOU ARE READY TO REQUEST A RECOMMENDATION

Provide the contact informationfor your teacher below.YOU MUST USE ENGLISH CHARACTERS OR YOU
WILL BE UNABLE TO REQUEST A RECOMMENDATION.NSLIY will use that information to send your teacher
an email message that contains a link to a secure, online recommendation form.
Once you have entered complete and correct contact information for your teacher, a new button titled
"Request Recommendation" will appear below your teacher's contact information.
Press the "Request Recommendation" buttonto send the email notification to your teacher. A record of
the dates you sent these messages will then appear below the contact information.
Warning!If youchangeyour teacher's email addressaftersending her or his notification message, it willcancelyour
previous request anddisablethe secure link to your teacher's online form. It will alsoeraseany online recommendation
form that was already in progressorhad already been submitted. So, be sure to consider this before changing the
contact information.An erased recommendation cannot be retrieved.
Provide Your Teacher's Contact Information

Provide all the information requested below:
First Name Last Name
Teacher Email Address
Teacher Telephone
Press the "Save Changes" button at the bottom of the page, and then press the "Request
Recommendation" button that appears to send an email request to your teacher.
IN TESTING: Confidential Teacher Recommendation
Status History
Date Activity Type Recipient Email

No status found.
Link text for recommender:
Delete
Add 1 More
AFTER YOU REQUEST A RECOMMENDATION

Confirm with your teacherthat he or she received the email message and can access the form.
If your teacher does not receive the email message, first suggest he or she check the spam or junk mail
box. If he or she still cannot find it, only then come back to this page and press the "Request
Recommendation" button again, to send another message.
Be careful! If you change your teacher's email addressafter sending the notification message, it will
cancel your previous request and disable his/her secure link to the online form. It will also erase any
online recommendation form that was already in progress or had already been submitted. An erased
recommendation form cannot be retrieved. Be sure to consider this before changing the contact
information.
To see if your teacher has started or submitted his or her recommendation form, periodically return to this
page and check the "Status History" table above.
QUESTIONS?
Contact NSLIY staff during normal business hours, 9:00 A.M.5:00 P.M. US Eastern Time, MondayFriday, at:
Statement Request Parent/Legal Guardian Statement
Deadline to Submit Statement: November 10, 2016, 4:00 P.M. U.S. Eastern Time
Your application must include a statement from one of your parents/legal guardians. It must be submitted
using this website (AIS Forms).
It is your responsibility to ensure that the parent/legal guardian statement is received by NSLIY.
If you or your parent have

trouble with the online parent
statement, please
contactnsliy@americancouncils.org.
BEFORE YOU REQUEST A PARENT/LEGAL GUARDIAN STATEMENT

Talk with your parent/legal guardianto determine if he or she is willing and able to provide this statement
for you. If your parent/legal guardian is not able to complete the statement in English, he or she can work
with a family member or close family friend to translate the statement. Individuals who have help
completing their statement should indicate who helped them in the written portion of the form. You
should not provide a translation for your parent/legal guardian.
Instructions for Your

Download this instructions document and give it to your parent/legal
Parent/Legal
guardian it explains how to submit the statement online.
Guardian
Tell your parent/legal guardian to expect an emailfromais_accounts@americancouncils.org. Suggest

that your parent/legal guardian add this address to his or her "safe" or "contacts" list so that the message
does not go into a spam or junk mail box. If he or she does not receive this email message, suggest that
he or she check the spam or junk mail box before contacting NSLIY.
WHEN YOU ARE READY TO REQUEST A PARENT/LEGAL GUARDIAN STATEMENT

Provide the contact informationfor your parent/legal guardian below.YOU MUST USE ENGLISH
CHARACTERS OR YOU WILL BE UNABLE TO REQUEST A STATEMENTNSLIY will use that information to send
your parent/legal guardian an email message that contains a link to a secure, online statement form.
Once you have entered complete and correct contact information for your parent/legal guardian, a
new button titled "Request Statement" will appear below your parent's/legal guardian's contact
information.
Press the "Request Statement" buttonto send the email notification to your parent/legal guardian. A
record of the dates you sent these messages will then appear below the contact information.
Warning!If youchangeyour parent's/legal guardian's email addressaftersending her/his notification message, it

willcancelyour previous request anddisablethe secure link to your parent's/legal guardian's online form. It will
alsoeraseany online statement form that was already in progressorhad already been submitted. So, be sure to
consider this before changing the contact information.An erased statement cannot be retrieved.
Provide Parent's/Legal Guardian's Contact Information
First Name Last Name
Relationship to You
Parent
Stepparent
Legal Guardian
Other
Parent/Legal Guardian Email Address
Parent/Legal Guardian Telephone
Press the "Save Changes" button at the bottom of the page, and then press the "Request Statement"
button that appears to send an email request to your parent/legal guardian.
IN TESTING: Parent/Legal Guardian Statement
Status History
Date Activity Type Recipient Email

No status found.
Link text for recommender:
Delete
Add 1 More
AFTER YOU REQUEST A PARENT/LEGAL GUARDIAN STATEMENT

Confirm with your parent/legal guardianthat he or she received the email message and can access the
form.
If your parent/legal guardian does not receive the email message, first suggest he or she check the
spam or junk mail box. If he or she still cannot find it, only then come back to this page and press the
"Request Statement" button again, to send another message.
Be careful! If you change your parent's/legal guardian's email addressafter sending the notification
message, it will cancel your previous request and disable his/her link to the online form. It will also erase
any online form that was already in progress or had already been submitted. An erased statement form
cannot be retrieved. Be sure to consider this before changing the contact information.
To see if your parent/guardian has started or submitted his or her statement form, periodically return to
this page and check the "Status History" table above.
QUESTIONS?
Contact NSLIY staff during normal business hours, 9:00 A.M.5:00 P.M. US Eastern Time, MondayFriday, at:
Placement Information Program Preferences

Please indicate your preferences for a NSLIY program language and duration. Language offerings are
subject to change in consultation with the U.S. Department of State.
AVAILABLE PROGRAMS
Summer 2017
To apply for one of these programs, your date of birth must be betweenJuly 10, 1998, and June 10, 2002
Arabic Summer
Chinese (Mandarin) Summer
Russian Summer
Korean Summer
Hindi Summer
Turkish Summer
Persian (Tajiki) Summer
Note:Due to recent events in Turkey, the 2016 NSLIY summer Turkish program was suspended. However,
in coordination with the U.S. Department of State, we will monitor the security climate over the next year
and hope to resume the NSLIY Turkish program in Turkey or in another location in 201718 if conditions
permit.
Academic Year 201718

To apply for one of these programs, your date of birth must be betweenSeptember 20, 1998, and June 30,
2002
Arabic Academic Year

Chinese (Mandarin) Academic Year
Russian Academic Year
Korean Academic Year
Hindi Academic Year
Turkish Academic Year
Note:Due to recent events in Turkey, the 201617 NSLIY academic year Turkish program was suspended.
However, in coordination with the U.S. Department of State, we will monitor the security climate over the
next year and hope to resume the NSLIY Turkish program in 201718 in Turkey or another location if
conditions permit.
1) Indicate Your 1st Preference:

1a) 1st Language Preference
Choose
1b) 1st Duration Preference

Choose
2) Indicate Your 2nd Preference:

2a) 2nd Language Preference
If no 2nd preference, choose "None"
Choose
2b) 2nd Duration Preference

Choose
3) Please explain your choice of language(s). Your explanation will be reviewed as a part of your application
and considered during the selection process please focus the explanation on your first preference. Keep
in mind that if you participated in a NSLIY summer program previously, you are only eligible to apply for
an academic year program. No NSLIY applicant is eligible for a third NSLIY program.
3a) IfAcademic Yearis one of your duration preferences, please explain why you are interested in
studying a rigorous language immersion program for an academic year (810 months).
4) Have you or do you plan to apply to other U.S. governmentsponsored exchange programs for 201718?
Yes
No
4a) If yes, please check any that apply: Assuming that you meet
CongressBundestag Youth Exchange (CBYX) the eligibility requirements, you
may apply to any of the
KennedyLugar Youth Exchange and Study (YES) Abroad following programs. Applying
to multiple programs will not
Youth Leadership or Youth Ambassador Programs impact the evaluation of your
Other NSLIY application. See the
NSLIY eligibility requirements
for more details.
4b) If other, please explain:
Placement Information Personal Preferences

Your responses to these questions about your placement needs and preferences willnot be
consideredduring the selection process. Collecting this preliminary information helps facilitate initial
placements should you be selected as a finalist for the program. Please provide information on any
personal needs or situations which may affect your host family.
PHYSICAL, HEALTH, OR LEARNING ACCOMMODATIONS

1) Do you have any physical restrictions and/or health conditions?
Yes
No
1a) In order to help NSLIY plan for your program safety and participation in everyday family and social
activities, please provide information about your physical restrictions and/or health conditions.
2) Do you have any disabilities (e.g., physical, sensory, learning, etc.)?

Yes
No
2a) If yes, please explain.
PET/ANIMAL RESTRICTIONS
3) What pets or other animals can you NOT live with?
CatsIndoors
CatsOutdoors
DogsIndoors
DogsOutdoors
Other Pets/AnimalsIndoors*
Other Pets/AnimalsOutdoors**
I have NO pet or animal restrictions.
3a) If you checked "Other Pets/AnimalsIndoors," please list:
3b) If you checked "Other Pets/AnimalsOutdoors," please list:
DIETARY RESTRICTIONS
4) Do you have any dietary restrictions, including any restriction for medical, religious, or selfimposed
reasons?
Yes
No
4a) If yes, please explain:
5) If you are vegetarian, will you eat any of the following?

Dairy Products
Eggs
Fish
Poultry
Other
None of the above
5a) If other, please explain:
RELIGION
6) What is your religious affiliation, if any?
Choose
6a) If other, please explain:
6b) If you indicated a religion above, how often do you participate in structured religious services?
Choose
6c) Do you require access to religious services?

Yes
No
7) Were you raised with a religious identity that is different than your current religious affiliation?
Yes
No
7a) If yes, please explain:
8) If your host family asked you to attend its religious services, would you do so even if your beliefs were
different from theirs?
Yes
No
SMOKING
9) Do you smoke?
Yes
No
9a) If yes, note that in some cultures, it is more difficult to find host family and school placements for
smokers. Smokers should please declare their intentions, as follows:
Choose one
I WILL smoke while participating in NSLIY
I WILL NOT smoke while participating in NSLIY
DISCLAIMER
I understand that I, along with my family, should research my host countries of interest in relation to everyday
living needs before selecting my language preferences. I understand that host environments might not be
able to accommodate the restrictions or requirements that I have indicated in my completed application. I
also understand that acceptance to NSLIY isnot a guaranteethat the noted above preferences can or will
be honored.
I have read and understand the above disclaimer:

Choose one
Yes
No
Acknowledged by:
Type your name
Placement Information Medical Information

While NSLIY is an invaluable experience and a time of tremendous growth for participants, it is important for
candidates and their families to understand that by its nature, NSLIY can be emotionally and physically
demanding. Being immersed in a different culture, placed in an unfamiliar host family, school, and community
often involves emotional stress during an adaptation period that varies from person to person.
If a candidate is currently experiencing medical, emotional, psychological, or family difficulties, or has recently
recovered from such issues, the demands of a study abroad program can severely exacerbate such
difficulties or be cause for relapse. For this reason, NSLIY requests as much information as possible be given
below regarding your health status. Your responses to these questions willnot be consideredduring the
selection process. Collecting this preliminary medical information helps facilitate program placement should
you be selected as a finalist for the program. More information on the medical review process can be found in
the NSLIY Terms and Conditions, which all applicants and their parent(s)/legal guardian(s) must thoroughly
review and sign.
If selected as a semifinalist, you will be required to have a physician complete the official NSLIY Medical
Evaluation formand return it to NSLIY. This form will be made available at the time of semifinalist notification.
Failure to submit this form by the stated deadline may result in cancellation of your application.
Do not submit a medical evaluation form with your initial application. It will not be accepted.
MEDICAL INFORMATION FOR PRELIMINARY REVIEW

1) Currently, are you taking any medication, or are you under any medical treatment?
Yes
No
a) If yes, please indicate the type of medication(s) or treatment(s), the reason for the medication(s) or
treatment(s), and the length of use. Also, please indicate if any medication is injected:
2) Do you have, or have you ever had, a prolonged illness?

Yes
No
a) If yes, please explain and include dates:
3) Do you have any allergies?

Yes
No
a) If yes, please explain the reaction and how you manage your allergies:
4) Do you have any dietary restrictions for medicallyprescribed reasons? Do not include lifestyle choices.
Yes
No
5) Have you consulted a neurologist, mental health therapist, psychologist, or psychiatrist within the past two
(2) years?
Yes
No
6) Cigarette smoke is prevalent in some NSLIY host countries. It may be difficult to find a nonsmoking host
family in some cultures. Is there a medical reason why you cannot be placed in a host family with one or
more family members who smoke?
Yes
No
CERTIFICATION
Applicants and their families should research their host countries of interest in relation to medical needs and
consult their physicians before determining their language preferences. Please note that, should you be
selected as a semifinalist, further consideration for a scholarship is contingent upon fulfillment of the medical
requirements of NSLIY. This includes, but is not limited to, submitting a completed health certificate on an
official NSLIY Medical Evaluation form by the stated deadline. This form will be provided to all semifinalists.Do
not submit a medical evaluation form with your initial application it will not be accepted.
7) I certify that the information I have provided above is truthful to the best of my knowledge, that I have
read the preceding statement, and that I understand that I will not be eligible for a NSLIY scholarship until
all medical requirements have been fulfilled:
Yes
No
Certified by:
Type your name
SelfIntroduction to Host Family and Language

Instructors
You may be hosted by a family, and just as you are curious about your host family and school, they will be
curious about you. Here is a chance to tell your prospective host family and school about yourself in a letter.
Below are several questions you need to incorporate into the body of your letter to communicate who you
are and your motivation for going abroad with NSLIY. Your letter must not exceed 500 words and must be
written in English. Please type your letter in the space provided below.
TIPS:
NSLIY recommends that youprepare and savethe host family letter and short essays in aword processing program, such as
Microsoft Word. You may copy and paste your essays into the spaces below once you have completed them in a word
processing program.
If you choose to type your essay directly into the form below,be sure to press the "Save Changes" button at the bottom of this page
every few minutes.This will ensure that your work is not lost if you encounter a technical problem.
A Note about Word Counts and Character Counts Used in this Online Application: Any minimum or maximum word or character
counts specified in the instructions for some questions will be as indicated by the counter tool used in this form. Please note that this
count may not be the same as counts indicated by Microsoft Word, OpenOffice.org Writer, or other wordprocessing tools.
Questions that You Must Answer in Your Letter:
How would your family and friends describe your personality?

How would you describe your relationship with your family and friends? For example, how are you
different from your brothers/sisters and friends? What is your role in the family? In what types of situations
do you seek advice from your parents?
What are your different roles in your community? For example, what are your roles in school, sports,
community activities, etc.? What is important to you?
If selected for NSLIY you will be part of a community and family, not a guest. Please explain how you
would adapt to a new community and family and what makes you a unique addition to a family and
community that will likely be different from your own.
In what ways have you prepared for the challenges of the NSLIY experience?
What are your education and career goals?
Your letter will be read as part of your application and may be shared with your host family or language
instructors, if you are selected. Consider formatting your response like an actual letter with a salutation and
closing.
Your Letter:
Essays
Summer applicantsmust write two (2), detailed essays about the topics listed below.Academic Year
applicantsmust write three (3) essays. Note the following:
Youmustcomplete essay 1 and essay 2.

For the first essay, you must answer the question provided.
For the second essay, choose one of the three offered topics.
For a third essay, only applicants withAcademic Year preferencesmust answer the question provided.
Each essay must not exceed 250 words and must be written in English. Please type your essays in the spaces
provided below.
TIPS:
NSLIY recommends that youprepare and savethe host family letter and short essays in aword processing program, such as
Microsoft Word. You may copy and paste your essays into the spaces below once you have completed them in a word
processing program.
If you choose to type your essay directly into the form below,be sure to press the "Save Changes" button at the bottom of this page
every few minutes.This will ensure that your work is not lost if you encounter a technical problem.
A Note about Word Counts and Character Counts Used in this Online Application: Any minimum or maximum word or character
counts specified in the instructions for some questions will be as indicated by the counter tool used in this form. Please note that this
count may not be the same as counts indicated by Microsoft Word, OpenOffice.org Writer, or other wordprocessing tools.
FIRST ESSAY
1) List and explain three (3) reasons why you want to participate in NSLIY.
SECOND ESSAY
2) Choose one of these three topics for your second essay:
(A) Describe a time in the past two years when you realized you were wrong about something.
What did you do? Why?
(B) Describe a time in the past two years when you were in an unfamiliar or uncomfortable situation.
How did you react? What was the result?
(C) Describe a time in the past two years when your first impression about someone or something
was wrong. What did you do and what did you learn from the experience?
Enter your second essay below: Âpplication_EssayFlexibilityAndAdaptabilityChooseTopic^
THIRD ESSAY (ACADEMIC YEAR APPLICANTS ONLY)

3) Describe a time in the past two years when you were working with others on a project and members of the
group disagreed with your ideas. What did you do?
Language Experience Knowledge of Languages

1) What is your native or first language?
English
Other
1a) If other, what is your native or first language?
1b) Do you speak English?

Yes
No
2) What language(s) are spoken in your home?
3) Have you studied or do you know any languages, EXCEPT English?

Yes
No
3a) Please tell us about your study of all the languages that you know, EXCEPT English.
(i) Language name:

Choose
(a) If Other, please list:
(ii) Length of study at time of application:

Choose
(iii) Are you currently studying this language in a formal classroom setting?
Yes
No
(iv) Setting(s) where language was studied:
Choose all that apply
College course
Exchange program
High school class
Junior high/middle school class
On your own
Primary school class
Saturday school class
Summer camp
Tutor
Other
(v) Which of these was theprimary settingwhere you studied this language?
Choose
(vi) Which of these was thesecondary settingwhere you studied this language?
Choose
Delete

4) Please describe any other foreign language experience you have that is not covered above.
5) Have you participated in aSTARTALKlanguage program?

Yes
No
5a) If yes, please list below the STARTALK programs you have attended:
# Language ProgramLocation ProgramYear
1 Choose
Language Experience SelfAssessment of NSLIY

Language Preferences
You have indicated the following NSLIY language preferences:
1st Language Preference:Âpplication_ProgramLanguage1^(Âpplication_ProgramDuration1^)

2nd Language Preference:Âpplication_ProgramLanguage2^(Âpplication_ProgramDuration2^)
See Section 15: Placement Information Program Preferences
NSLIY provides beginning, intermediate, and advanced language instruction. This information will assist us with
assigning you to an appropriate level of language class in your NSLIY program.
1) Have you studiedÂpplication_ProgramLanguage1^language in a formal classroom setting, have you
studiedÂpplication_ProgramLanguage1îndependently, or isÂpplication_ProgramLanguage1^spoken
in your home?
Yes
No
2) Have you studiedÂpplication_ProgramLanguage2^language in a formal classroom setting, have you
studiedÂpplication_ProgramLanguage2îndependently, or isÂpplication_ProgramLanguage2^spoken
in your home?
Yes
No
SELFASSESSMENT OF 1ST LANGUAGE PREFERENCE:ÂPPLICATION_PROGRAMLANGUAGE1^

1a) Please respond to the following statements about yourÂpplication_ProgramLanguage1^language study
experience, as well as your ability to use and understandÂpplication_ProgramLanguage1^.
Your responses will assist us with assigning you to an appropriate level of language class in your host school.
Please be honest and accurate about your proficiency.
(i) Have you studied Âpplication_ProgramLanguage1^ in a formal classroom setting?

Choose
(a) If yes, which textbooks have you used in your studies?
(b) If yes, what is your expected length of formal classroom study as of June 2017?
Choose
(ii) Have you studied Âpplication_ProgramLanguage1^ independently?

Choose
(a) If yes, which resources, online applications, and/or software have you used in your studies?
(b) If yes, what is your expected length of independent study as of June 2017?
Choose
(iii) Have you received an official rating from a certified language test in
Âpplication_ProgramLanguage1^ (i.e. ACTFL, HSK, STAMP, TORFL, TOPIK, or another languagespecific
test)?
Choose
(a) If yes, please list the name of the test.
(b) If yes, please list your rating.
(c) If yes, please list the date of the rating.
(iv) I can ask and answer simple questions about my name and place of birth, make social introductions
and use greeting and leavetaking expressions. I can describe myself in basic terms.
Choose
(v) I can read and understand the purpose and meaning of very short, familiar, simple written texts such as
printed notes, ads, or signs.
Choose
(vi) In everyday conversation with people speaking standard dialect, I can understand speech if it is slow
and clear.
Choose
(vii)I can give detailed information about my family, my house, and my community.
Choose
(viii)I can speak in an organized fashion on topics beyond my basic routine.

Choose
(ix) I can listen to and understand simple communications on familiar topics, including descriptions of
events, feelings, wishes, and future plans.
Choose
(x) I can read and understand uncomplicated stories about current, past, and future events.
Choose
(xi) I can accurately listen to and follow all conversations among native speakers who are speaking at a
normal rate of speech.
Choose
(xii)I rarely find myself unable to finish a sentence because of language limitations and there are few
grammatical features of the language that I try to avoid.
Choose
(xiii)I can usually read and understand all the material in a major daily newspaper.
Choose
(xiv)I am completely fluent and can express myself as well in the target language as in my native
language.
Choose
Delete
Add 1 More
SELFASSESSMENT OF 2ND LANGUAGE PREFERENCE:ÂPPLICATION_PROGRAMLANGUAGE2^

2a) Please respond to the following statements about yourÂpplication_ProgramLanguage2^language study
experience, as well as your ability to use and understandÂpplication_ProgramLanguage2^.
Your responses will assist us with assigning you to an appropriate level of language class in your host school.
Please be honest and accurate about your proficiency.
(i) Have you studied Âpplication_ProgramLanguage2^ in a formal classroom setting?

Choose
(a) If yes, which textbooks have you used in your studies?
(b) If yes, what is your expected length of formal classroom study as of June 2017?
Choose
(ii) Have you studied Âpplication_ProgramLanguage2^ independently?

Choose
(a) If yes, which resources, online applications, and/or software have you used in your studies?
(b) If yes, what is your expected length of independent study as of June 2017?
Choose
(iii) Have you received an official rating from a certified language test in
Âpplication_ProgramLanguage2^ (i.e. ACTFL, HSK, STAMP, TORFL, TOPIK, or another languagespecific
test)?
Choose
(a) If yes, please list the name of the test.
(b) If yes, please list your rating.
(c) If yes, please list the date of the rating.
(iv) I can ask and answer simple questions about my name and place of birth, make social introductions
and use greeting and leavetaking expressions. I can describe myself in basic terms.
Choose
(v) I can read and understand the purpose and meaning of very short, familiar, simple written texts such as
printed notes, ads, or signs.
Choose
(vi) In everyday conversation with people speaking standard dialect, I can understand speech if it is slow
and clear.
Choose
(vii)I can give detailed information about my family, my house, and my community.
Choose
(viii)I can speak in an organized fashion on topics beyond my basic routine.

Choose
(ix) I can listen to and understand simple communications on familiar topics, including descriptions of
events, feelings, wishes, and future plans.
Choose
(x) I can read and understand uncomplicated stories about current, past, and future events.
Choose
(xi) I can accurately listen to and follow all conversations among native speakers who are speaking at a
normal rate of speech.
Choose
(xii)I rarely find myself unable to finish a sentence because of language limitations and there are few
grammatical features of the language that I try to avoid.
Choose
(xiii)I can usually read and understand all the material in a major daily newspaper.
Choose
(xiv)I am completely fluent and can express myself as well in the target language as in my native
language.
Choose
Delete
Add 1 More
Review and Submit

Application Deadline: Âpplication_DeadlineDate^
FINAL REVIEW OF APPLICATION

Before you submit your application, please be sure to review all sections. Make sure you have answered all
the questions and required fields, and that you are satisfied with your responses. Also, be sure that you have
downloaded any documents that must be submitted separately by mail.
Once you submit your application, you will no longer be able to make changes to any section of the
application. You will be able, however, to continue to view your application online via this system with your
existing login.
If you are not ready to submit your application, please press any "Save Changes" button in the application
forms and log out of the system. You will be able to log in at any time, thereafter, until the application
deadline, and continue to complete or edit your application.
CERTIFICATION
I certify that:
Everything in this application is complete and true to the best of my knowledge

I understand that by submitting my application to the National Security Language Initiative for Youth
(NSLIY), I am agreeing to apply for a competitive scholarship
I understand that American Councils for International Education cannot provide individualized
application feedback and
I understand that my application is in no way an offer or a guarantee of an offer for a NSLIY
scholarship:
Select one:
Yes
No
Certified and Agreed by:
Type your name
SUBMIT YOUR APPLICATION

If you are ready to submit your application, press the "Submit" button below. If you do not click the "Submit"
button, your application materials will not be reviewed by the selection committee.
If you have left any required questions unanswered, you will receive an error message at the top of this page
after you press the "Submit Your Application" button and your application will not be accepted. You may then
return to your application and enter any missing information, and then attempt to resubmit your application.
QUESTIONS?
Contact NSLIY staff during normal business hours, 9:00 A.M.5:00 P.M. U.S. Eastern Time, MondayFriday, at:

NSLI Y 2017-18 Application Sample PDF

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National Security Language Initiative for Youth, 2017-18

About the Application Table of Contents and

SECTIONS OF THE APPLICATION

APPLICATION DEADLINE AND SUBMISSION OF REQUIRED DOCUMENTS

Postmarked No Later than

Send Grade Transcript documents to:

ATTN: NSLIY File Processing (#1100G)

About the Application How to Apply

When emailingnsliy@americancouncils.org, please use the following subject line convention:Reference

HOW TO USE THIS ONLINE FORM

Saving Your Work

Completing Your Form in Multiple Sessions

Submitting Your Form

Downloading Documents from this Website

Uploading Documents and Photographs to Your Form

Legal First Name Legal Middle Name Legal Last Name

2) Your Preferred Nickname

Program Duration Eligible Birthdate Range

7) U.S. State or Possession of Birth

PASSPORT AND CITIZENSHIP

YOUR CONTACT INFORMATION

11) Street Address

13) U.S. State or Possession

14) ZIP/Postal Code

15b) Street Address

15d) U.S. State or Possession

15e) ZIP/Postal Code

16) Primary Telephone Type

17) Alternate Telephone Type

18) Other Telephone, if any Whose Telephone is this "Other Telephone?"

19) Primary Email Address Ensure that your email

20) Alternate Email Address

CONGRESSIONAL VOTING DISTRICT

22) District Number or At Large

Personal Information School Information

3) School Name If you are homeschooled,

9) School Website If you are homeschooled,

Personal Information Family Information

a) Legal First Name Legal Last Name

d) Does this person have legal custody of you?

f) Primary Telephone Type

g) Alternate Telephone Type

h) Other Telephone Type

0 characters counted.Maximum of 255 characters allowed.

(ii) If no, enter your parent's/legal guardian's physical address below.

(iii) Street Address

(v) U.S. State/Possession

(vi) ZIP/Postal Code

Add 1 More Add 2 More

ABOUT YOUR SIBLINGS

(i) Legal First Name Legal Last Name

Add 1 More Add 2 More

ALTERNATE EMERGENCY CONTACT

a) Legal First Name Legal Last Name

d) Primary Telephone Type

e) Alternate Telephone Type

f) Other Telephone Type

Add 1 More Add 2 More

Personal Information Certify Your Eligibility

Personal Information International Experience

c) Which organization implemented your program?

0 words counted.Maximum of 250 words allowed.

2) Have you previously participated in any other international exchange program(s)?