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Wildlife Conservation Society Bridging The Gap Student Application 2013
Wildlife Conservation Society Bridging The Gap Student Application 2013
Directions
Please complete the following questions to the best of your ability. Your application is a direct
reflection of you- please write legibly and neatly. In addition to your application, a statement of
support from a teacher, guidance counselor, or other school staff member must be completed
and included with your application at the time of submission.
Apartment # _________
Borough: ____________________________________
Email: ______________________________
) __________________
Ethnicity:
Asian
African American
Caucasian
Latin/Hispanic
Native
American
Other:________
Gender:
Male
Female
Yes
No
GPA: __________
Teacher
School
administrator
School counselor
Fellow student
Other:_______
Score:
This program involves direct contact with the animals from the Departments handling
collection. Please list and explain any medical issues (such as allergies to fur, feathers, hay, or
pine shavings) that might affect your participation in this program. Do you currently have any
medical issues that could possibly preclude you from participation?
Please circle one: YES
NO
10
Score:
________________________________
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3
Score:
2. Will you be able to meet the attendance & participation requirements as outlined in the Bridging the
Gap Program Overview Sheet? Please circle one: YES
NO
3. What is/ are your strongest subject(s) in school? Why do you consider this/these subject(s) to be your
strongest?
________________________________________________________________________
________
________________________________________
4. What is/ are your weakest subject(s) in school? Why do you consider this/these subject(s) to be your
weakest?
________________________________________________________________________
________________
________________________________________________________________________________________________
5. At the current time, are there any science-related careers that interest you? Please name these careers.
_______________________________________________________________________________________
___________________________________________________________________________________
6. Are you interested in pursuing a career field that is not science related? If so, please tell us what field(s)
interests you and why.
_______________________________________________________________________________________
_______________________________________________________________________________________
________________________________________________________________________________
7. Do you prefer to work alone or with others? Explain your answer.
_______________________________________________________________________________________
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8. Describe any involvement you have had with animals (pets, dog/cat sitting, etc).
__________________________________________________________________________________________________________
______________________________________________________________________________________________________
Score:
Bus
Walking
Subway
Car
10. Have you obtained information on any colleges and/or universities that you might be interested
in attending? Please Circle one: YES NO
If you answered YES, please tell us which colleges and/or universities?
_______________________________________________________________________________________
___________________________________________________________________________________
11. Have you had a conversation with your guidance counselor regarding your interest in the above
mentioned schools and/or taking the SAT or ACT for admission? Please Circle one: YES NO
If you answered YES, please answer the following question (11A):
11 A. What was the result of your conversation with your guidance counselor? Have you
received additional information on the colleges/universities in which you expressed interest?
Were you given guidelines as to when you should apply for and take the SAT or ACT? Explain.
_______________________________________________________________________________________
___________________________________________________________________________________
12. Are you involved in any extracurricular activities? If so, what activity and how many times a week
and/or what time of year do you participate?
_______________________________________________________________________________
________________________________________________________________________________
___________________________________________________________________________________
13. What additional information would you like to add in order to help us make a decision about your
acceptance into the program?
_______________________________________________________________________________________
___________________________________________________________________________________
Student:
I, _________________________________, have filled out this application honestly and to the best of my ability.
Signature of Student
Signature of Student
Date
Parent/Guardian:
** Parental consent is not needed if applicant is over the age of 18**
I, _______________________________________ (Parent Name) have read the Bridging the Gap
program overview distributed by Wildlife Conservation Society along with reviewing my
sons/daughters application. I understand and accept the conditions of this program and the extent of
my commitment and the commitment of my son or daughter.
Signature of Parent/Guardian
Date
Print Name
Instructions to Applicant
Refer this form to a sponsor (teacher or school administrator) familiar with your academic record and
personal character and have them complete it and return it to you. Make sure that your sponsor has
signed the form and included their contact information. Attach this form to your completed
application.
Please print neatly or type the following information:
Instructions to Sponsor
In order to complete the application process for Bridging the Gap, each applicant must include a
statement of support from an appropriate sponsor. In the space provided below or on a separate sheet
(please use official stationery), please provide a statement concerning the aforementioned applicant.
Be sure to indicate how long you have known the applicant, and why you feel he/she would be a good
candidate for Bridging the Gap.
Check only one.
I strongly recommend the applicant without reservation.
I recommend the applicant.
I recommend the applicant with reservation.
PLEASE EXPLAIN YOUR CHOICE BELOW.
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___________________________________
_________________________________________
Signature of Sponsor
Phone: (
) _________________________
Name (Print)
Email: ____________________________________