Elon in New York City 2010

June 4, 2010 – August 6, 2010

Contact: or call 336-278-5724 for more information.

Personal Information (please print or type)

Name: ______(first) (middle) (last)

Social Security or Elon ID #: ______Date of Birth (mm/dd/yyyy) ______/___/______

Sex: _____ Male _____ Female Year in School: ___Freshman__ Sophomore ___Junior

Current mailing address: ______Major: ______

City, State, ZIP: ______Current phone number, best time: ( ) ______

Preferred E-mail address: ______

Permanent address: ______

City, State, ZIP: ______Home phone: ( ) ______

Please indicate the name and address to be used for billing and other mailings (Permanent or Current):

______

Parent or Guardian Information

Parent or guardian name(s):______

Address: ______

City, State, ZIP: ______Home phone ( ) ______

Work: (____)______E-mail: ______

Commitment to Program

This application must be accompanied by an unofficial copy of your Elon University transcript.

Application is due by March 1, 2011 or December 10 for early action, accompanied by a deposit of $500. The full amount will be due by May 1, 2011. After April 1, 2011, any student registered for the Elon in NYC program will be responsible for all expenses incurred as a result of Elon preparing for their participation in this program.

I, ______am aware of the financial schedule of payment and understand that after April 1, 2011, all expenses incurred by Elon University on the student’s behalf will be the responsibility of the student.

______

(Student Signature)( Date)

PARENT/GUARDIAN'S SIGNATURE /DATE (Required if student is not responsible for bills)

______

(Parent/GuardianSignature)( Date)

RETURN COMPLETED APPLICATION AND OTHER REQUIRED PAPERWORK TO McEwen 004

Elon in New York 2011

June 4, 2011 – August 6, 2011

Academic Recommendation (please print or type)

APPLICANT: Please complete the information below and give this form to a faculty member in your major (or minor for non majors) who knows you well enough to provide an informed assessment of your academic strengths and weaknesses.

I, am applying for admission to the Elon in New York City program

Name (please print): ______

In compliance with the Family Education Rights and Privacy Act of 1974, as amended:

(√ check one)

___This evaluation will remain confidential; I waive my right to view it.

___This evaluation will not remain confidential; I do not waive my right to view it.

______

(Student Signature)( Date)

REFERENCE: Due March 1, 2011 or December 10 for early action. Please complete this form and email it to or mail it to: Elon in NYC CB 2850 Elon NC 27244 or FAX (336)278-5734

**If necessary, continue your responses on an attached page. PLEASE DO NOT WRITE ON THE BACK OF THIS FORM.

1. How long and in what capacity have you known the applicant?

______

2. Please evaluate the candidate in the following areas:

Characteristic / Above Average / Average / Needs Improvement
Overall Academic Performance
Communication Skills
Class Participation
Reliability
Maturity
Independence

3. Please comment on the candidate's strengths and weaknesses relevant to his/her ability to perform an internship in New York. We are especially interested in the candidate’s ability to live in a new community:

______

Name (please print): ______

______

(Signature)( Date)

Title: ______Phone: ______

Elon in New York 2011

June 4, 2011 – August 6, 2011

or call 336-278-5724

Business/Work Recommendation (please print or type)

I, am applying for admission to the Elon in New York City program

Name (please print): ______

In compliance with the Family Education Rights and Privacy Act of 1974, as amended:

(√ check one)

___This evaluation will remain confidential; I waive my right to view it.

___This evaluation will not remain confidential; I do not waive my right to view it.

______

(Student Signature)( Date)

REFERENCE: Due March 1, 2011 or December 10 for early action. Please complete this form and email it to or mail it to: Elon in NYC CB 2850 Elon NC 27244 or FAX (336)278-5734

**If necessary, continue your responses on an attached page. PLEASE DO NOT WRITE ON THE BACK OF THIS FORM.

1. How long and in what capacity have you known the applicant?

______

2. Please evaluate the candidate in the following areas:

Characteristic / Above Average / Average / Needs Improvement
Maturity
Flexibility
Positive Attitude
Work Ethic
Ability to Work with Others
Independence

______

Your name (please print): ______

______

(Signature)( Date)

Title: ______Phone: ______