Center for Strategic and International Studies Seminar
March 10-14, 2019
STUDENT APPLICATION FORM
Completed applications must be submitted as a single packet no later than Friday, November 16, 2018 either electronically
toĐƐŝƐΛƐĞŵŽ͘ĞĚƵŽƌas hardcopy to the Office of the Provost, Academic Hall 13ϭ͘
Name of Applicant _______________________________________________ SE ID#_____________________
College, School or Department of Applicant______________________________________________________
Academic Major/Minor ______________________________________________________________________
Primary Campus of Attendance: ☐ Cape Girardeau ☐ Kennett ☐ Sikeston
Jane Stephens Honors Program: ☐ Yes ☐ No
Number of Credit Hours Anticipated as of Dec. 31, 2018 ______ (minimum ≈60 hours)
Anticipated Graduation Date _______________ (December 2019 or later)
Grade Point Average, current as of Sept. 1, 2018 __________ (minimum of 3.00)
Phone: _____________________________ ^E-Mail Address: ________________________________
Permanent Address: ͺͺͺ________________________________________________________________
Current Address: ͺͺͺ___________________________________________________________________
Attach the following documents:
• One-page resume that describes leadership activities and provides evidence of academic excellence
• Statement describing your interest in participating in this seminar (500 words or less)
• One letter of reference from a Southeast faculty or staff member
Provide the names and contact information of two additional references, one of whom must be a Southeast
faculty or staff member.
Additional reference #1: ____________________________________________________________
Additional reference #2: ____________________________________________________________
______________________________________________________ __________________
Applicant Signature (electronic signature accepted) Date
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signature
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