SCB application – page 2

STUDENTS CROSSING BORDERS (SCB) COMMUNITY

APPLICATION FORM

The Students Crossing Borders community will be housed on the 3rd and 4th floors of Middlebrook Hall tower and will bring together U.S. and international students who possess a globally-engaged mindset to create an out of the classroom, cross-cultural learning environment. Submission of this supplemental application is NOT an application for housing at the University of Minnesota. This document is a supplemental application for the SCB community only.

Current U of M Housing Residents: The priority deadline to apply is March 1, 2013. More details on page 2 below.

Please return this application to: rStudents Crossing Borders

c/o Stephanie Brownlee

Comstock Hall East

210 Delaware St. SE

Minneapolis, MN 55455

Last Name (Family Name)First Name (Given Name)Middle Initial

U of MN Email address:@umn.edu Student ID Number:

Country of citizenship or country of permanent residency:

Permanent Address:

Major/Intended Major:

Date of Birth: Gender: Female

Month/Day/Year Male

Transgender

Academic Year 2013-2014Status - Please check one:

Freshman Sophomore Junior Senior Graduate Student

I will be attending the University of Minnesota

Fall 2013 and Spring 2014

Fall 2013 only

Spring 2014 only

It is the expressed desire of the Students Crossing Borders community to create and foster cross-cultural learning opportunities, both in the community and in roommate pairings. In order to facilitate this in our assignment process, indicateyour primary nationality/cultural identity:

Roommate preference information:

I prefer aU.S. student roommate I prefer someone from outside the US as aroommate

I have no roommate preference (if you have no preference, skip to questions below)

I prefer as a roommate*

Last Name (Family Name)First Name (Given Name) Middle Initial

*note: Requested roommates who have not previously applied for the community must also submit an application and be accepted into the program in order to secure their spot in SCB community

If you have requested a roommate and they did not apply for the SCB community, they will not be placed in the community with you. Under these circumstances, do you prefer to be placed elsewhere with the requested roommate or in the SCB community without the requested roommate? (Indicate one)

Roommateor SCB Community

If you are not accepted due to space limitations, would you like to be considered for the waiting list?

Yes No

(If an opening became available, you would be contacted and offered a space in the SCB community.)

SCB CLASS

Preference to the community and room assignments will be given to students who enroll in the SCB-only section of Personal Leadership in the University. Are you planning to enroll in this course?

Yes No Maybe, please send me more information

This course is OLPD 1301W and satisfies the University’s Writing Intensive requirement. This section is being taught in Middlebrook for members of the SCB community only.

REQUIRED SUPPLEMENTAL QUESTIONS

In order to assist us with selection of community members and appropriate roommate placements, please answer the following questions. The combined answers should be no more than one page.

  1. Why do you want to live in the Students Crossing Borderscommunity, and how would living in this environment enhance your experience at the University of Minnesota?
  2. What experiences, ideas, and characteristics will you contribute to the community (including language(s) spoken, study abroad experience, international travel experience, interest in cross-cultural experiences, etc.)?

HOUSING ASSIGNMENT PROCESS

RETURNING RESIDENTS:

  1. Complete this application and return it by March 1.
  2. Students Crossing Borders is available during the room re-application process through a special LLC sign-up process during the LLCround (February 19th). More information about all returning LLCs can be found at
  3. Log on to the Room Reapplication site at beginning at 9:00am on February 19th-February 20th at noon.
  4. If you have not completed the Intent to Return process, you will complete it and then be allowed to sign up for a room. You will select “LLC Reservation Hall”. You will have the option to sign up for a specific room type but not an actual room. You will have the option to select a roommate (who must also complete the application for the community).
  5. After the sign-up process, Housing staffwill review the application.If accepted, you will be assigned to a space in the SCB Living Learning Community. (If not accepted, you will be assigned to a similar hall and room type.)
  6. If you have questions, please send an email to and put “LLC Reservation Hall” in the subject line.

As part of the Students Crossing Borders community, I understand that I will be encouraged to share about my culture and explore other cultures by building relationships with other students in the community and by participating in events and activities that promote cross-cultural learning among international and U.S. students. I understand that I might not get my preference in roommate or room assignment. I further understand that by submitting this application, my acceptance to this program is not guaranteed until confirmed by Housing & Residential Life.

If you have any questions, please contact us at:

Signature: Date:

(Type if filling out electronically)