Cultural Connect Friendship Program
Center for International Education
Application
Cultural Connect
Center for International Education
1701 Wright St.
Room D1620
Madison, WI 53704
culturalconnect@madisoncollege.edu
Personal Information
Last Name
First Name
Cultural Background
Gender
Email Address (preferable Madison College email)
Home Country
Madison College Student ID Number
Degree Program/Area of Study
Expected Graduation Year/Semester
Current Residence Information (in case we need to send you something)
Street Address
Street Address Line 2
City
State
Zip
Home Phone Number
Cell Phone Number
Cultural Connect Friendship Program
Center for International Education
Application
Cultural Connect
Center for International Education
1701 Wright St.
Room D1620
Madison, WI 53704
culturalconnect@madisoncollege.edu
International Interest
I am interested in participating as:
An international partner (paired with a U.S. student)
A U.S. partner (paired with an international student)
Have you studied, worked or lived outside of your home country?
Yes
No
If yes, where, when and for how long?
What areas of the world interest you most? Why?
Do you speak other languages besides English?
Yes
No
If yes, which ones and how well?
Cultural Connect Friendship Program
Center for International Education
Application
Cultural Connect
Center for International Education
1701 Wright St.
Room D1620
Madison, WI 53704
culturalconnect@madisoncollege.edu
Partner Preferences
What qualities are important to you in a Cultural Connect Partner?
Describe Yourself
My favorite hobbies are:
I would describe myself as:
Listening to music
Outgoing
Watching movies
Direct
Baking/cooking
Adaptable
Playing an instrument
Laid-back
Watching sports
Positive
Biking
Structured
Skating
Critical
Dancing
Understanding
Playing sports
Serious
Skiing
Loud
Playing video games
Quiet
Shopping
Flexible
Hiking
Shy
Reading
Playful
Traveling
Patient
Eating
Anxious
Others:
Others:
Cultural Connect Friendship Program
Center for International Education
Application
Cultural Connect
Center for International Education
1701 Wright St.
Room D1620
Madison, WI 53704
culturalconnect@madisoncollege.edu
Short Essays (3 or 4 sentences minimum)
Why would you like to be a Cultural Connect Partner?
What do you hope to gain from participating in the Cultural Connect Program?
Please provide at least 3 facts or characteristics about yourself.
Cultural Connect Friendship Program
Center for International Education
Application
Cultural Connect
Center for International Education
1701 Wright St.
Room D1620
Madison, WI 53704
culturalconnect@madisoncollege.edu
Availability
List 3 times and days you are able to meet with your Cultural Connect Partner
Time:
Day of the Week:
to
to
to
Additional availability:
to
to
to
***If your availability changes, please let us know ASAP ***
Disclaimer and Signature
I certify that my answers are true and completed to the best of my knowledge. I
understand that finalists will be interviewed and notified of acceptance. If I am
selected, I agree to attend all mandatory Cultural Connect activities and events
(approximately 5 per semester). By submitting this application, I give my
permission for my application to be shared with my future Cultural Connect
partner, if I am selected.
Signature
Date
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signature
click to edit