Houghton in the Balkans
IMPORTANT: PLEASE READ:
The application committee may consult Academic Records and Student Life offices as part of your application process. If you wish to check the status of your application or have not received notification that we received your application within 7 days, please email:
ocp@houghton.edu
.
Personal Information
First Name
Middle Name
Last Name
Gender
Female
Male
Date Of Birth
Country Of Birth
Citizenship
Social Security Number
Ethnicity
Marital Status
Single
Married
Religion
Address Information
Parent's Name
Home Phone
Street
City
State
Postal Code
Email
Health Information
General Health
Excellent
Good
Fair
Please list and explain any ailments you may have (e.g.: none, asthma, diabetes, allergies, etc.)
Please list any diet concerns you may have (e.g.: none, lactose intolerance, vegetarian, etc.)
Have you personally dealt with any of the following?
Depression
Eating Disorders
Other Emotional Struggles
Are you currently receiving treatment? (Type yes or no)
If yes please explain.
Are you willing to provide a physician's clearance if accepted to this program? (Type yes or no)
Are you willing to receive all required immunizations and precautionary treatments necessary for this program's location? (Type yes or no)
Academic Information
What college are you currently attending?
College address:
CPO#
Street
City
State
Postal Code
Student Phone Number
Email
Have you participated in an Off Campus Program before? (Type yes or no)
Program?
If you are not a Houghton College Student, please provide us the following information so we can contact the person on your campus who is responsible for approving study abroad. If your institution does not have an Off-Campus Programs or Study Abroad Office, please enter the name/e-mail address of your school Registrar.
Name
Email
Phone
Please list your major(s)
Please list your minor(s)
What is your current status?
First Year Student
Sophomore
Junior
Senior
What is your projected graduation date?
5/13
12/13
5/14
12/14
5/15
12/15
5/16
12/16
5/17
12/17
5/18
12/18
5/19
12/19
5/20
12/20
Other
What is your overall GPA (if not available enter NA)
What is your GPA in your major?
I give the Admission Committee of this program permission to review my academic transcript: (Type yes or no)
FACULTY RECOMMENDATIONS
We will be requesting recommendations from two faculty members to accompany your application. One recommendation should come from your advisor; the other should be from another faculty member of your choice. Each one should be able to evaluate your maturity, flexibility, emotional stability, academic preparedness and motivation for off campus study. Please provide the appropriate names and email addresses. They will automatically be contacted with information on how to provide the recommendation.
We recommend you contact the individuals you will be listing before submitting their name here.
Advisor's Name:
Advisor's Email Address:
Faculty Member Name:
Faculty Member Email Address:
Program Specific Questions
I am applying to participate in the Fall semester of the year
Please check items that apply.
Do you have a passport?
When does your passport expire?
BALKANS HEALTH INFORMATION
Houghton in Balkans is a physically challenging program including communal living, warm, humid weather and other physical challenges. Group-living dynamics also challenge the student socially and personally for the three month period.
How do you feel you are equipped to handle hiking, climbing and both hot and cold weather conditions? Do you have any reasons that these conditions might prove too difficult for you?(Yes or No)
If so, please explain.
If you have taken Lifetime Wellness or a similar Health/Fitness class at your institution, would you allow your professor to comment on your ability to do well in a physically challenging environment?(Yes or No)
If so, please provide the name and email address of your Lifetime Wellness instructor
Instructor's Name:
Instructor's Email:
COURSE OPTIONS
Course Requirements:
All students must take the core course
Balkan and East European History: Early Middle Ages to Present
Which of the elective courses are you interested in pursuing? (tick three)
Theology: Catholic, Orthodox, Muslim
Literature of Central and Southeastern Europe
Fine Arts of Catholic, Orthodox, and Muslim Cultures
Independent Study (if you tick this, give discipline. If able to do so, give indication of topic in no more than 30 words.)
STATEMENT OF INTENT
After reviewing the proposed course offerings and co-curricular aspects of studying in Balkans, briefly describe what you hope to learn by participating in the program, how you have prepared for this educational experience, and how this program fits into your future goals, both academic and personal. Please limit your answer to 150 to 400 words.
Type your initials in lieu of your signature: