GPA 2014-15 Application Form

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Welcome to the GPA 2014-15 Application!

Thank you for considering GPA for the upcoming year!

Information on GPA dates and program can be found on gpafamily.com

Early Bird application, which entails no application fee, begins on March 1st and will end on April 15th.

Application will continue after April 15th with a $70 non-refundable application fee, to be paid for by credit card upon submission.

If you have any questions on the application process please email us at applygpa@gmail.com

How to apply

Fill out the application form online and fill in all required fields. If any of the fields do not apply to you, please insert N/A.

It is suggested that you start a document on the local drive on your computer with all the written portions of this document. This Application may NOT save your progress and should be completed in one sitting or session.

Once submitted, you will receive an email from GPA staff regarding the phone interview, which will determine admittance to the program.

Requirements to Apply:

To apply to GPA you must fulfill the following requirements:

1) Be an American citizen or have a valid green card or social security number

2) Turn 18 by December 31st 2014*.

3) Have graduated High School or completed a GED by September 2014

* If you do not turn 18 by Kick-Off workshop, download the Parental Consent form from gpafamily.org and email it to us

What you will need to apply:

Personal Information Valid Passport Information Emergency Contact Medical History 2 Recommendation Letters 2 Essays Tuition/Payment

A typical gap-year program would cost $25,000 a year. In understanding families’ financial situations, the total tuition for GPA is $4000 and the rest of the program cost is supplemented by fundraising.

A breakdown of program cost can be found on gpafamily.com, and if you cannot fundraise for any reason, you will be expected to pay the allotted amount indicated.

Tuition for the program can be broken into installments.

$2000 down payment by August 1st and $200 a month starting from September 1st OR $1500 down payment by August 1st and $250 a month from September 1st OR $1000 down payment by August 1st and $300 a month from September 1st

More information will be sent by email upon acceptance to the GPA program.

Pre-Fundraising:

There will be a pre-fundraising period for anyone who wishes to fundraise towards his/her GPA tuition. 50% of the gross result will go towards to tuition and the other 50% towards operational costs.

There is limited space on the fundraising teams, and you can only apply after having been accepted onto GPA on a first come first serve basis.

Personal Information

First Name Middle Name Last Name Gender Photo: Please choose a portrait picture of yourself and upload it. Personal Cell Phone Number Personal Email Address Home Phone Number Birthday T-Shirt Size Home Address Are you matched? Are you blessed? If yes to either question, what is your match/spouse’s name? Match/ Spouse’s country of residence

Passport Information Name (written as on passport) Date of Birth (mm/dd/yyyy) Gender Passport Nationality If your passport is not American, do you have a Green Card or American Social Security Number? Passport Number Passport Expiration Date: Please have a passport valid between August 2014 and June 2015 BEFORE Kick-Off workshop in September 2014.

Please upload and attach a photo of the photo ID page of your valid passport. If you do not currently have a valid passport, please have it ready by the time you arrive to GPA.

Health Information

Health Insurance Carrier Primary Care Physician (PCP) PCP Phone Number

Medical History: Please indicate any past or present health conditions, allergies, diabetes, previous injuries, broken bones, etc. This information will not have effect on your acceptance to GPA.

Medication: Please list any past or present medications taken.

Have you ever been diagnosed with an emotional or psychological disorder? If yes, please explain. This information will not affect your acceptance into GPA.

Shots and Vaccinations

To further secure your health and safety, we ask you be updated in the vaccinations for:

Tetanus MMR (measles, mumps, rubella)

Hepitatis A and B Meningitis

Please indicate the date of your last tetanus shot (mm/yy) Please indicate the date of your last MMR shots (mm/yy) Please indicate the date of your last hepatitis A and B shots (mm/yy) Please indicate the date of your last meningitis shot (mm/yy)

Emergency Contact Information

Mother’s (Legal Guardian’s) Name Mother’s (Legal Guardian’s) Cell Phone Mother’s (Legal Guardian’s) Email Address

Father’s (Legal Guardian’s) Name Father’s (Legal Guardian’s) Cell Number Father’s (Legal Guardian’s) Email Address

1st Emergency Contact Name 1st Emergency Contact Cell Number

2nd Emergency Contact Name 2nd Emergency Contact Cell Number

High School/ College Information

Note: You will NOT be able to apply to colleges, defer from college, take the SAT’s or ACT’s during the GPA year.

Will you have graduated High School by August 2014?

Have you applied to college for the academic year of 2014-15?

Where will you being going to school, and what is your status (acceptance, deferred, pending, not attending college etc.)?

Recommendation Letters

Please upload 2 recommendation letters:

1) One from a church community leader such as a Youth Pastor, District Leader or Council Member, Center Leader, etc.

2) The other should be from a community member not from the church, such as an employer, a guidance counselor, teacher, etc.

Please write up to 500 words responding to the following prompts:

Essay 1: Why do you want to join GPA? What are your hopes and/or hesitations regarding GPA?

Essay 2: What are your aspirations for the future and how do you see GPA helping you achieve it?

Additional Comments

Please add any additional comments about your personal situation and/or family situation the program staff should be aware of (ex. previous obligations, special concerns, requests, etc.).

Code of Conduct

I agree to the following statements:

All the information provided in the above application is correct and current to the best of my knowledge.

I will abstain from any illegal activity.

I will abstain from smoking, alcohol, drugs, and sex for the duration of the GPA year.

I will not engage in exclusive relationships.

I will not initiate any matching processes during the GPA year.

I will not willingly/ knowingly compromise my safety or that of others.

I will not permanently modify my body during GPA (piercings, tattoos, etc.).

I will abide by the GPA rules and guidelines and respect GPA staff.

I understand that any violation of these statements can result in phone calls home, warnings towards suspension from the program, suspension, or expulsion from the program.