Brookline‐Xi’anChinaExchangeProgram 2014‐2015 Thisapplicationmustbecompletedonline,exclusivelybytheapplyingstudent! ProgramDescription:EightBrooklineHighstudentsandateacherfromBHSwillspend the spring semester of the 2014‐2015 school year at the Gao Xin #1 School, the top performingschoolinShaan’xiProvince,Xi’an,China.Thisfour‐monthstayinXi’anispart of the Brookline High‐Gao Xin China Exchange Program, one of a few semester‐long US public school exchange programs with a sister school in China. In the preceding fall semester,theGaoXin#1SchoolwillsendeightstudentsandateachertoBrookline.Our groupwillbecloselyinvolvedwithourXi’anvisitorsduringtheirstaywithus. Selected students for the 2014‐2015 school year will be drawn primarily, though not exclusively,fromthosecurrentlyenrolledinBrooklineHigh’sChineselanguageprogram and all are required to take an intensive Mandarin language course during the late summerof2014.Thesummerclasswillmeetfortwoweeks,threehoursperday.Inthefall semester,participantswillmeetregularlywiththeirGaoXinpeersandwiththeteacher, and they will continue to study Mandarin through Brookline High’s Chinese program. Studentsshouldhavetheinterestandcapacitytobegloballeaders,understandandadapt to cultural differences, be open‐minded and willing to experience and adapt to new experiences. We strongly encourage each participant’s family to be a host home for one of our Xi’an guestsintheFall.Theexchangeprogram’sgoalistobuildfriendshipandunderstandboth betweenourtwohighschoolsandourtwocultures. The selected students and teacher will leave for China on or around February 1, 2015, soonaftertheirXi’anfriendshaveleftBrooklinetoreturnhome.Theywilllivewithhost families in Xi’an, attend classes at Gao Xin, and explore 5000‐year‐old Xi’an, the most famous ancient capital city in China with its extraordinary Terra‐Cotta soldiers. Xi’an’s cultural heritage is especially rich because it was the terminal of China’s ancient “Silk Road,”whichconnectedEuropeand Asiafortradeandculturalexchanges.Studentswill alsotraveltoShanghai,Hangzhou,Yunnan,BeijingandotherimportantsitesinChina. Eligibility: Students will be selected on the basis of the following criteria: strong academic records; interest in and aptitude for learning Chinese language, history and culture; ability to serve abroad as student‐ambassador from Brookline and the United States; sensitivity to other people and cultures; and successful completion of the applicationandinterview. Page 1 ApplicationswillbeavailableonlinestartingFebruary9,2014at: http://bhschinaexchange.weebly.com ApplicationDeadline:Monday,March3,2014.Interviewswillbearrangedsuring themonthofMarch.Finaldecisionsforthe2014‐2015programwillbemadeby March31st. Oncethere,please:  Completetheapplicationelectronically.  Printoutthecompletedform.  Signontherequiredlinesforparents/guardiansandstudent.  Sendbothanelectroniccopyoftheapplication,andprintoutacopywith appropriatesignaturesandhandtoMr.SteveLantos,theBHS‐GaoXinChina ExchangeProgramCoordinatorinRoom358,ScienceDept.,BHS. HandwrittenapplicationswillNOTbeaccepted. Costs:Weestimatethatthestudent/family’sshareoftheexpensesinthisprogramwillbe approximately$4400,dependingonairlineticketprices.Yourcontributioncoversthe following;books,airfare,travel(to/fromChinaandwithinChina),visaapplicationfeeand processing.Tuition,roomandboardwhileinChinaarecovered.NOTINCLUDEDISTHE TUITIONOFTHESUMMERLANGUAGECOURSE(approximately$450perstudent),AND SPENDINGMONEY.Werecommendapproximately$500perstudenttocarrytoChinafor theSpringsemester. Iffinancialcostsareaconcern,theCHEXProgramhasfundsavailableforfinancialaid. Pleasenoteaninterestforfinancialneedontheapplication.FINANCIALNEEDINNOWAY AFFECTSASTUDENT’SCONSIDERATIONFORPARTICIPATIONINTHECHEXPROGRAM. Languages:AllstudentsgoingontheexchangewillbeexpectedtostudyChinese intensivelyFORTWOweeksduringthelatesummer(2014)andduringthefallsemester. Theclassdatesandlocationtobedetermined. Questions: There will be three informational meetings for students during X‐Block on February6thand13th,andT‐BlockonFeb.11th.MeetingswilltakeplaceinRoom 358 (Science Dept). Mr. Steve Lantos, the BHS‐China Exchange Coordinator, will run these meetings, with a CHEX alum to answer questions. If you are not available during either X‐Block or T‐Block, please visit Mr. Lantos after school by appointment at: [email protected] Page 2 STUDENTAPPLICATION Name:______________________________________________________________________________________ HomeAddress:____________________________________________________________________________ HomeTelephone:__________________________________ E‐mail:_____________________________ GuidanceCounselor:_______________________________Homeroom:_______________________ Teachers(fullnameofteacher)duringthe2013‐2014schoolyear,(includesubject) Teacher_____________________________ BLOCK_______ROOM________Subject______________ Teacher_____________________________ BLOCK_______ROOM________Subject______________ Teacher_____________________________ BLOCK_______ROOM________Subject______________ Teacher_____________________________ BLOCK_______ROOM________Subject______________ Teacher_____________________________ BLOCK_______ROOM________Subject______________ Parent/Guardian’sName:____________________________________________________________________________________ Address:__________________________________________________________________________________ ljlj DaytimePhone:________________________________cell:________________________________ EveningPhone:________________________________ Emailaddress:__________________________________________________________________________________(pleaseprint) Parent/Guardian’sName:____________________________________________________________________________________ Address:__________________________________________________________________________________ DaytimePhone:________________________________cell:________________________________ EveningPhone:________________________________ Emailaddress:__________________________________________________________________________________(pleaseprint) AlternativeEmergencyContactintheU.S Name:________________________________________________________RelationshiptoApplicant:_______________________ Address:__________________________________________________________________________________ DaytimePhone:____________________Emailaddress:___________________________________________________________ TravelDocumentPreparation: PlaceofBirth:___________________________________________ (County,State,Country) Student’spresentcountryofcitizenship:__________________________________________ SignatureofStudentApplicant:___________________________________________________________Date_______________ SignatureofParents/Guardians: _________________________________________________________Date________________ _________________________________________________________Date________________ Page 3 StudentApplicant’sPersonalInterests: Pleasecompletethefollowingquestionsasfullyaspossible: Pleasedescribeanyexperienceyouhavehadwiththestudyoflanguages,inparticularanyexperience youhavehadwithMandarin.(Includeyearsstudied,namesofschools&teachers,experienceathome, withtravel,etc.)Whois/areyourcurrentlanguageteacher(s)? IfyouhavenotalreadybeenstudyingMandarin,whatisyourinterestindoingso? Travel: Previoustravelexperienceisnotacriterionforeligibility.Butbecausedistance,timeandcultural differenceareallsignificantfactorsinthisexchange,wewouldlikeyoutodescribeanytimeawayfrom homeortraveling. Pleasedescribeanytimespentlivingawayfromhomeortraveling.Whodidyoutravelwithandforhow long?Whywasthismeaningful?Whatweresomeofthechallengesforyou? You: Usefourwordsorphrasestodescribeyourself. Describeyourhomeandfamily.Ifyouhavesiblings,whataresomepositiveandnegativeaspectsof having(a)brother(s)/sister(s)athome?Howwouldhavinganotherteen(intheFall)inthehouseimpact yourfamily? Whatisyourfavoritesubjectinschool?Why? Whatclubs,sports,activitiesdoyouenjoyandwhy? IdentifyTWOteachersatBHSandbrieflytellhowtheymightdescribeyouasastudent‐learnerin theirclasses. Page 4 Thefollowingquestionsareintendedtogiveyouanopportunitytoreflectupontheexperience forwhichyouareapplying.Pleasereadallofthequestionsbeforebeginningtocomposeanswers. Whydoyouwanttoparticipateinthisprogram? Whydoyouthinkthatafour‐monthstayinChinarepresentsaparticularlydemandingchallenge? Whydoyoufeelthatyouarewellqualifiedtomeetthischallenge?Thisshouldincludeboth academicsandpersonalchallenges. Researchaplace/somethingthatinterestsyouaboutChina.Wherewouldyouliketovisitandwhy? WhatpartofChinaisitin?Wewouldlikeyoutothinkbeyondthetypicaltouristareassuchasthe GreatWallandTerracottaWarriors. BHSisaninternationalcommunity.Theschoolfostersinternationalawarenessandlearning.What canbeyourpersonalcontributionandhowwillyouapplyit? Whatattractsyoutotheopportunitytobepartofalargerglobaleducationexperience?Haveyou doneordoyouplananythingalreadythatdemonstratesapassionandstrongintenttobecomea globalcitizen?Thiscanincludeactivities,specialprograms/clubs,travel,schoolandotherevents. Page 5 Hosting: Westronglyencourageall2014‐2015participantstohostoneoftheChinesestudentswithusintheFall semester.Thisisaninvaluablepartofourexchangeprogramandwonderfulwayforyourfamilytolearn moreabouttheculture,language,andcustomsofourGaoXinguests. CanyourfamilyhostoneofourXi’anstudentguestsduringthefallsemester(fromapproximately September1toFeb1.)? Yes No Hostfamilieswillformatightnetworkamongeachothertoshareideas,responsibilitiesandtoplan occasionalgatherings.EachhostfamilywillalsoplanitsownoutingswiththeirChineseguestand establishtheirownhouserules. IfyoucannothostoneofourXi’anstudentguests,youneedtobeabletorecommendaninterested family.Pleaselistthename,addressandphonenumberofapotentialhostfamilyyouknowwellandcan recommend.Weverymuchappreciateyourhelp! Name: ____________________________________________________________________________ Address: ___________________________________________________________________________ PhoneNumber:____________________________ Emailaddress:____________________________________________________________________________ References: Pleaselisttwoteacherswhowouldbeabletoserveasareferenceforyou. 1. ____________________________________________________________________________ 2. ____________________________________________________________________________ (Optional)Ifyouwouldliketoprovideanother,non‐academicreference(boss,musicteacher, counselor/advisor,etc.),pleasewritehis/hername,phonenumber,andconnectiontoyou.Whydidyou chosetoincludethisindividualaspartofyourapplication? Page 6