General Application Form for Summer 2013

Columbia University International and Immigrant Family Health and AIDS Programs

Application Date: ______

Please answer the following as fully and accurately as possible to enable us to assess your request.

1. GENERAL INFORMATION

Full name and title:Preferred name:

Institutional e-mail:Personal e-mail:

Cell Phone:Skype:

Age:

Current School:Program:Year:Expected Graduation:

Current/most recent employer:Supervisor:E-mail/telephone:

Employer address:Occupation & position:

Current address:Citizenship:

Telephone number (home/cell):Telephone number (work):

PLEASE INDICATE YOUR PROGRAM PREFERENCE BY NUMBERING BELOW:

La Romana 6/14-8/4
(Early decision)
WH Spanish Immersion
6/17-8/9 / La Romana
6/14-8/4
(Regular decision)
Evening Spanish Classes 6/17-8/9 / Santiago, DR 6/14-8/4 / Santo Domingo, DR
6/14-8/4

LANGUAGE PROFICIENCY

Using the criteria below, please rate your language proficiency in:

Language / Fluent / Conversant / Intermediate / Beginner
English
Spanish
Haitian Kreyol
French
Other (specify)

2. BRIEF ESSAY:

Please write and attach a single-spaced essay no less than 300 words and no more than 500 words on what you are looking for in your summer experience(s) and what are additional skills and experiences, either not included on your resume or that you may want to highlight.Examples of topics you may want to cover are:

What are your professional and personal goals? What are your general career goals? What is your experience with Spanish language and culture? What are your hobbies? Include any special areas of interest that you would like to pursue whether you arein the Dominican Republicor Washington Heights for the summer, and whatever else you consider relevant. If you are applying to the Washington Heights Inwood Spanish Language and Cultural Program, please let us know if you have a program, project or mentor in place or in mind. Also, if you have any other summer commitments that overlap with the program you are applying for, please let us know.

3. RESUME OR CURRICULUM VITAE: INCLUDE AN UPDATED VERSION AS PART OF THIS DOCUMENT

Note on references and contact information:

Please note that if applicable, we will approach your current/last employer for a reference. We may need to ask you for other references later on.

Make sure to use your official school address if applicable. Otherwise please tell us the e-mail you use regularly and make sure to notify us of any change to your personal information as needed.

PLEASE SEND ALL MATERIALS IN A SINGLE MICROSOFT WORD OR PDFFILE (COMPLETED APPLICATION; ESSAY; CV/RESUMÉ).

PLEASE NAME FILE WITH THE FOLLOWING FORMAT: “ FIRST NAME, LAST NAME, IFHAP APPLICATION 2013” (E.g. Jane Doe IFHAP Application 2013)

PLEASE SEND ALL MATERIALS TO:

  • Ana Jiménez-Bautista, IFHAP – Director of Programs,
  • Dr. Stephen Nicholas, IFHAP Founder and Director,

If you are applying for the Washington Heights and Inwood Spanish Language & Cultural Immersion Program, please cc: Rozan Abdulrahman at .

We Look Forward to Reviewing Your Application

1

Summer Programs 2013 Application

LANGUAGE PROFICIENCY CRITERIA: Fluent: native speaker or very advanced non-native speaker; can take a medical history and understand everything a patient and relatives say; can give a lecture on a familiar subject in the language, as easily as in your native language; can write a report with correct grammar. Conversant: can understand much of what's going on, but would not be able to give a lecture without practice; can communicate, administer questionnaires, and instruct patients on taking medicines; can write notes in Spanish, fill out forms. Intermediate: can order food and get around, but help is needed in detailed communication, such as comforting afamily member, following guidelines in the non-native language, or participating in a meeting; can follow an adult conversation much of the time. Beginner: can form some sentences and understand simple comments or commands; an interpreter is needed for most interactions.