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T F S
TRANSITION FOR SUCCESS
APPLICATION GAP YEAR / INTERSHIP PROGRAM
Instructions:
Complete this application as directed. Mail application, together with high school transcript and two letters of recommendation to Weinfeld Education Group, 104 Northwood Avenue, Silver Spring, MD 20901.
Section 1 to be completed by applicant:
NAME_________________________________________________________________
ADDRESS______________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
PHONE _____________________________ (home) ________________________(cell)
EMAIL________________________________________________________________
DATE OF BIRTH________________________________________________________
HIGH SCHOOL ATTENDED______________________________________________
DATE OF GRADUATION OR EXPECTED GRADUATION_____________________
Section 2 to be completed by parent/guardian:
NAME_________________________________________________________________
ADDRESS (if different from above)__________________________________________
_______________________________________________________________________
_______________________________________________________________________
PHONE_______________(work)_________________(cell)________________(home)
EMAIL_________________________________________________________________
RELATIONSHIP TO APPLICANT__________________________________________
Section 3 to be completed by applicant. You may use the space provided, or attach a separate sheet of paper.
LIST YOUR AREAS OF INTEREST, AND ANY RELEVANT CLASSES OR WORK EXPERIENCE RELATED TO YOUR INTERESTS
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Section 4 to be completed by applicant. Personal Statement: Please attach a separate, typed sheet.
PLEASE DESCRIBE WHY YOU ARE APPLYING FOR THE GAP YEAR/INTERNSHIP PROGRAM, AND WHAT YOU HOPE TO LEARN FROM THIS EXPERIENCE. THIS SHOULD BE NO MORE THAN ONE TYPED PAGE.
Section 5 to be completed by both applicant and parent or guardian.
Affidavit: I certify that all of the above information is accurate.
Signature of applicant__________________________________________________
Date______/_______/________
Signature of parent/guardian_____________________________________________
Date______/_______/________
*The cost of the semester gap year/internship program is $2850, payable upon acceptance to the program. There is no application fee.
Please contact Mrs. Janet Price, Director of Transition Services at pricetag@earthlink.net, or (301) 467-2740 if you have any questions regarding the program or the application process.
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