West Bank EducationUSA Center

AMIDEAST
Competitive College Club Application
2016-2017 academic year

Personal Information
Name:

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Home Address: _____________________________________________________________

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Contact Telephone(s): _____________________
Birth date (mm /dd / yy): ___________________

Email Address: ______________________

Gender: M

Mothers current occupation and workplace: _________________________________________

(Please write Currently Unemployed if so, or N/A if you are from a single parent
family. See below for other circumstances.)
Fathers current occupation and workplace: _________________________________________
(Please write Currently Unemployed if so, or N/A if you are from a single parent
family. See below for other circumstances.)
Academic Information
School Name and Address:_______________________________________________________
Grade: ________
Expected Date of Graduation: _____________________________________________________
School Telephone Number: ______________________
Headmaster/Headmistress Name: _________________________________________________
Subjects you are taking. Please indicate which of these is your strongest subject.
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List below all schools you have attended and which grade years you did at each
school:
School
Location
Grade Year Completed

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List the extra-curricular clubs, sports and activities that you participate in at high
school and in you community and/or religious organisation. Please circle the one to
which you devote the most time and energy.
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Please describe which one of these activities has the most meaning for you and why.
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Short Answer Questions

Feel free to use additional paper if the space is insufficient.
1. What do you hope to study at university? What is your planned career? Feel free
to mention more than one potential field of study and career path.
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2. List all prizes, honours or awards you have received during high school.
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3. What else should we know about your background, your family and your financial
condition?

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4. Selection for US universities is highly competitive. Why should they select you
over other highly-qualified students? What makes you unique?
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5. Choose one of the following topics and write an essay with maximum of 600 words:
1. Some students have a background, identity, interest, or talent that is so
meaningful they believe their application would be incomplete without it. If
this sounds like you, then please share your story.

2. The lessons we take from failure can be fundamental to later success.

Recount an incident or time when you experienced failure. How did it
affect you, and what did you learn from the experience?

3. Reflect on a time when you challenged a belief or idea. What prompted

you to act? Would you make the same decision again?

4. Describe a problem you've solved or a problem you'd like to solve. It

can be an intellectual challenge, a research query, an ethical dilemma
- anything that is of personal importance, no matter the scale. Explain its
significance to you and what steps you took or could be taken to identify a
solution.

5. Discuss an accomplishment or event, formal or informal, that marked

your transition from childhood to adulthood within your culture,
community, or family.
Attach the following documents to application:

1. 9th and 10th grade transcripts in addition to eleventh grade (1 st semester) when
it is available.
2. SAT I and SAT II subject test score reports (if available)