Lingnan Foundation W.T. Chan Fellowships Program 2014Application Form

PERSONAL INFORMATION

Name (English/Pinyin):
Last/Family Name / First Name
姓名(中文):

EDUCATION

List only secondary and higher education institutions, beginning with your current university first.

Dates Attended / University & Department/School Name / Location
(City, Country) / Subject/Field of Study / Degree/Certificate Obtained/Expected / YearObtained/Expected
WORK EXPERIENCE

List any previous work experience, beginning with the most recent.

Dates / Company/Organization Name / Job Title and Description
EXTRACURRICULAR, VOLUNTEER AND/OR SERVICE EXPERIENCE

List any non-academic, volunteer and/or service-related experience (during secondary school or later), beginning with the most recent first.

Year/Month (List by most recent date) / Organization Name / Total number of hours volunteered for the organization / Description

HONORS AND AWARDS

List any honors/awards received at secondary school and university level, beginning with the most recent.

Award Name/Description / Awarding Organization Name / Date Received
TRAVEL EXPERIENCE
How many times have you visited the U.S. before?

If you have visited other countries, including the US, for holiday or academic exchange, please give details below:

Date(s) of Visit / Country Visited / Reason for Visit / Length of Visit

APPLICANT STATEMENT

The statement below must be signed and dated by the applicant, and submitted with the printed copy of for his/her application to be considered for the W.T. Chan Fellowships Program.

By signing below, I hereby certify that the statements and information contained herein are true, complete and accurate to the best of my knowledge. I hereby certify that the essays are entirely my own work. I am awarethat the decision of the Fellowship administrator is final and that any false, fictitious or fraudulent statements or claims may result in revocation of any award that may have been granted to me.

Applicant’s Signature: Date:

ESSAY Questions

Please give responses of 500 words or less to each of the following four (4) questions.

  1. Participants selected to take part in the W.T. Chan Fellowships program will gain international understanding and practical work experience through community service in the U.S.A. Please explain why you are interested in applying for this opportunity? What do you expect to get out of this experience?
  1. Analyze and describe a current and ongoing social issue that is impacting your local community or country today. Why does this issue interest you? Have you taking any direct or indirect actions to address this issue?
  1. Name one person that you admire and describe how he or she has influenced you?
  1. Lingnan Foundation values diversity by welcoming individuals who represent different groups as defined by ethnicity, gender, sexual orientation, socioeconomic background, age, disability, and religion. Do you come from a diverse background? How has your background helped to shape who you are?

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