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COMMUNITY COLLEGE INITIATIVE

STUDENT APPLICATION 2021-2022
Before completing this application, you must read all of the information at
https://co.usembassy.gov/es/education-culture-es/community-college-initiative-cci/. On this website, you will
find complete information about the Community College Initiative (CCI) Program, eligibility requirements,
application requirements, additional required documents that must be submitted, and deadlines.

Please complete all questions on this application in English. If the question does not apply to you, write N/A.

Personal Information
Full name (as listed on cédula)

First Name: Elian

Second Name: Enrique
Last Names: Mosquera Perea

Address where you live Phone number: 3148460314

Street and number: Street 106 A Cr 68 B House 65-28
City: Apartado
Department: Antioquia E-mail: elian.rey2@gmail.com

Gender: Male Marital status: Date of birth:

☒ Single Month: April
☐ Married Day: 09
Year: 2000
Age: 20

Country/Countries where you are a citizen: Where were you born?

City: Apartado
Country: Colombia

Have you participated in any programs related to the U.S. Embassy? Yes ☒ No ☐
If yes, program name: English Access Microscholarship Program

Year(s) you participated: 2 Years

English Proficiency
English exam or certificate you are using to meet the English language requirement to apply for the CCI Program:
Name of English exam/certificate/program: English Access Microscholarship Program
English level: B1

Remember that in order to be considered for the program, you must provide a certificate or results that clearly shows a
minimum B1 level or equivalent (Common European Framework).

Proposed Field of Study

Applicants must apply in only one field of study. Select your preferred field of study from the options below.
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Then, select two or three concentration areas in that same field of study and note the order of your
preference. The concentration areas all must be in the same field of study.

Field of Study Concentration Area Rank Order Preference

(choose 1): (choose 2 or 3): (1 is highest, 3 is lowest)

☐Agriculture ☐Agribusiness 1☐ 2☐ 3☐
☐Agricultural Geospatial Technology 1☐ 2☐ 3☐
☐Agricultural Production Management 1☐ 2☐ 3☐
☐Animal Science 1☐ 2☐ 3☐
☐Environmental Horticulture and Conservation 1☐ 2☒ 3☐
☐Parks and Natural Resources 1☐ 2☐ 3☒
☐Small Scale Food Production 1☒ 2☐ 3☐
☐Sustainable Agriculture 1☐ 2☐ 3☐
☐Applied ☐Architecture 1☐ 2☐ 3☐
Engineering ☐Automotive Technology or Service Management 1☐ 2☐ 3☐
☐Computer Aided Design 1☐ 2☐ 3☐
☐Construction Management 1☐ 2☐ 3☐
☐Electro Mechanical Technology 1☐ 2☐ 3☐
☐Electrical Systems Maintenance 1☐ 2☐ 3☐
☐Electrical Technology 1☐ 2☐ 3☐
☐Electricity and Electronics Technology 1☐ 2☐ 3☐
☐Heating Ventilation and Air Conditioning 1☐ 2☐ 3☐
☐Machine Repair: Automated Systems 1☐ 2☐ 3☐
☐Manufacturing Technology 1☐ 2☐ 3☐
☐Mechatronics 1☐ 2☐ 3☐
☐Robotics 1☐ 2☐ 3☐
☐Welding 1☐ 2☐ 3☐
☐Early ☐Administration of an ECE Center 1☐ 2☐ 3☐
Childhood ☐Early and School-Age Care Specialist 1☐ 2☐ 3☐
Education ☐Early Childhood Education and Development 1☐ 2☐ 3☐
☐Special Education 1☐ 2☐ 3☐
☐Information ☐Computer Information Systems (CIS)/Computer Science (CS) 1☐ 2☐ 3☐
Technology ☐Computer Internetworking Technologies (CIT) 1☐ 2☐ 3☐
☐Geographic Information Systems (GIS) 1☐ 2☐ 3☐
☐IT Technician: Desktop Support, Computer Support, Network Technician 1☐ 2☐ 3☐
☐Media ☐Digital Media/Animation 1☐ 2☐ 3☐
☐Film Studies/ Motion Picture/ Television 1☐ 2☐ 3☐
☐Graphic Design 1☐ 2☐ 3☐
☐Journalism 1☐ 2☐ 3☐
☐Public & Media Relations 1☐ 2☐ 3☐
☐Social Media Marketing 1☐ 2☐ 3☐
☐Web Design 1☐ 2☐ 3☐
☐Web Development 1☐ 2☐ 3☐
☐Public Safety ☐Fire Sciences, Protection and Safety 1☐ 2☐ 3☐
☐Emergency Services 1☐ 2☐ 3☐
☐Tourism and ☐Hospitality and Hotel Management 1☐ 2☐ 3☐
Hospitality ☐Culinary Arts and Restaurant Management 1☐ 2☐ 3☐
Management ☐Meeting, Event, and Exhibition Planning 1☐ 2☐ 3☐
☐Tourism 1☐ 2☐ 3☐
Background Information

Educational History

Are you currently a student? ☒ Yes ☐ No

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Name of institution: Politecnico Grancolombiano
How many semesters have you completed?
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Please fill out the following chart based on your educational history. Start with your current or your most recent
institution. Please list information for your high school studies and for any studies (technical/vocational,
university, etc.) after high school.

Location of When did you When did you What is/was

Have you
institution start your finish your your area of
Name of institution received a
(city, studies? studies? study?
degree?
department) (Month/Year) (Month/Year)

SENA Apartadó- April-2017 April-2019 2 years ago. Natural

Antioquia Resources.
Politécnico Apartadó- October-2019 October-2022 Port Management
Grancolombiano Antioquia

Have you received a scholarship or funding for any of your studies? ☒ Yes ☐ No
If so, please describe the scholarship:

I received a scholarship from the government of Antioquia, which is called Higher Corpoeducation, this scholarship is an
open call, which helps young people from areas in conflict territories to professionalize for life, this scholarship gives me
the opportunity to access to a better quality of life, learn more, grow as a person and be able to the benefits of higher
education.

Work Experience
Are you currently employed? ☐ Yes ☒ No

List the jobs you have had, beginning with your current or most recent employment.

When did you

When did you
Name of company or start
Position title stop working? Job responsibilities
employer working?
(Month/Year)
(Month/Year)
Sara Palma Environmental 10,2018 04,2019 Protection of fauna and flora, saw
practitioner of vegetable species, sensitize
people, and make works in soil
protection and others.
Training Corp English Teacher 10,2019 11,2019 Give English Classes, Preparing
their.

Leadership and Community Service Experience

Leadership and community service are fundamental parts of the CCI program and the selection process. Please list any
experience you have as a volunteer and/or any experience as a participant or leader in extracurricular activities or
organizations.
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.
When did When did
Leadership
Title or name of you start the you finish the Describe your involvement in this
position held (if
project/activity activity? activity? project/activity
applicable)
(Month/Year) (Month/Year)
Everything by Apartadó Leader or the March, 2019. November, The Everything By Apartadó
Main 2019. collective was born on March 9,
Committee 2019, in the municipality of
Apartadó-Antioquia, is made up
of the students of the Alfonso
López educational institution,
and, I was linked after the
volunteer work I did after the
floods of the On October 28 of
the year 2019, the focus of the
group is to generate awareness
and environmental impact on
the society, make planting
campaigns of plant species,
carry out environmental
awareness activities for
riverside communities, make
days of solid waste collection
and projects for mitigate the
impacts that negatively affect
the municipality due to
problems of erosion,
deforestation, wildlife
trafficking, air quality,
arborization and gardening in
green areas, parks and
neighborhoods, the role I fulfill
is to relate my profile as a
Technologist in Natural
Resources Management is to
guide the team of the group in
the activities that are going to
be carried out Tsar, make the
Gothic martyrs to carry out the
activities successfully, guide the
team and give
recommendations regarding
what species we can sow in
each space, whether in a river,
slope, mountain, stream or
green area.
Apartado Juventud Volunteer January, The project I am part of this group of young
Lider 2019 is in force. people, since it began, it is a
group that, through social and
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community work, seeks to
promote values.
In which we are participants.
My participation as such in this
group is a volunteer position,
but as such I have a leadership
role, since they let me
coordinate small groups to do
tree planting activities,
maintenance of gardens and
parks, recycling, making objects
with material recycling, delivery
of masks in rural and urban
areas, delivery of non-
perishable food for vulnerable
families, awareness days on
protection measures against the
global pandemic, delivery of aid
in neighboring municipalities in
case of natural disasters, aid
collection day, planning
donations to preserve life,
participation in forums,
meetings, encounters and
exchanges of knowledge with
other exponents of the youth of
my municipality, region and
department.

Have you ever traveled outside of Colombia? ☐ Yes ☒ No

If yes, please fill out the following information for any trips outside of Colombia:

Travel start Travel end

Purpose of travel:
date date Who paid for the expenses
Country/Countries visited vacation, studies, work,
(month/day/ (month/day/ related to your trip?
other (explain)
year) year)

How did you find out about the CCI Program? (Check all that apply.)

☒ U.S. Embassy social media

☐ Social media account of other institution
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☐ Friend or family member
☒ EducationUSA
☐ Former grantee
☐ Other – please explain:
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QUESTIONS

For all questions below, please type your answers below or on the following page. Please follow the word
limits listed with each question.
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Short Answer #1 (maximum 125 words)
Describe growing up in your home. Explain where you grew up, who lived in your home with you, what your
parents’ job responsibilities were during your youth (if they were employed), and what your surrounding
community was like.

R: In fact I remember very well my childhood, complete and developed since I was little I liked helping others;
The truth is I grew up in two environments, one was an environment that is constantly affected, by natural
disasters, which are currently being affected, that is why I focused on volunteering by vocation but not by
conviction, to help the people we really need, the other side is that I grew up in a neighborhood relocated by
natural disasters and I really focused on strengthening environmental awareness. Currently I live with my
parents, my father is a bricklayer and my mother is a housekeeper in a service company, my community is very
sociable.
Short Answer #2 (maximum 125 words total)
a.) What does leadership mean to you?
R: // For me, leadership implies a great responsibility, it includes leading a group of people for a common good,
all the people in the group have the same goal, and all people have the ability to lead; In addition to being a
good leader, you have to believe in the group's abilities, obviously all opinions are very important, but based on
opinions, a central idea is worked out so that all members of the group, a leader is the one who exerts an
influence positive in people to enhance the value that both common and personal goals bring, to be a leader you
have to take into account certain qualities, for me a good leader is one who trusts himself and others.

b.) Do you consider yourself a leader? If yes, what is an example of a time when you demonstrated
leadership?
R: Yes, I consider myself a leader, there have been many moments in which I have applied leadership, but the
most fundamental of all, was when my municipality and community began to have deficiencies in aspects such
as food, health, medicines and others, due to confinement left by the pandemic, that is why, within the Youth
Leader Section, we began to deliver food to the populations vulnerable, elderly, disabled, childhood and
foreigners, later, we gave help from house to house, to prevent people from leaving and minimize risks, we
made disposable masks; We carry out these activities in both urban and rural areas, we carry out health brigades
and campaigns for vaccination, sterilization and adoption of street animals.

Short Answer #3 (maximum 125 words)

Please describe a problem or obstacle in your educational or personal life. How did you overcome it?
R: In fact, I have had very difficult moments in my life but my family has been a fundamental pique to
overcome my obstacles; When I received the C-Note scholarship, the truth was not easy because I was studying
on the other side of the municipality, so I had something difficult, which is not the exception, because it was not
the best of the course, but I realized in certain cases, months later I had the opportunity to be in Access, I
accepted, I entered at 1:00 pm and left school at 12:30 pm, I walked every day, whether it was sunny or rainy,
although it was Late, I always tried to stand out among my colleagues, which was partially successful.

Short answer #4 (maximum 125 words)

The CCI Program prioritizes students from underserved or underrepresented communities. Describe how these
criteria applies to you.

R: I belong in two communities, I belong to a group that seeks to promote the Afro culture in the region, to
make ourselves known because it is important to value our black skin, in addition to that. , seeks to help us with
scholarships, to access higher education, exchanges in this case and the other community is an organization that
is responsible for protecting, representing and guiding the rights of the LGTBIQ community, since our
community has gone through situations in which many people do not accept The fact that a person, is
homosexual or transgender, that is why the Diverse Network, which is where I am from, participates, we seek to
promote the good habits of the community that at this moment is vulnerable.
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COMMUNITY COLLEGE INITIATIVE PROGRAM

APPLICATION CERTIFICATION STATEMENT

I certify that I completed this application myself, that the information given in this application is complete and
accurate, and that I have carefully read and understand it.

I certify that I have read and I understand all of the information about the program on the U.S Embassy
Community College Initiative webpage:
https://co.usembassy.gov/es/education-culture-es/community-college-initiative-cci/.

I understand that program administrators reserve the right to verify all the information listed in the application.
I understand that giving false or misleading information in the application will eliminate me from the
competition or cause my dismissal from the Community College Initiative Program.

I acknowledge that I am aware of the following program requirements:

 I must follow all program rules and regulations and observe all the laws of the United States during my stay
there.
 At the end of the academic year program, I will return to my home country and fulfill a two-year, home-
country residency requirement in compliance with the terms of my J-visa. I understand that I may not
extend my program dates.
 The health benefits coverage provided to me during my travels is intended only for emergencies and does
not cover pre-existing or dental conditions.
 My spouse, children, other relatives or individuals are not permitted to accompany me to the United States
on the program.

AGRICULTURE 12/02/2021
_________________________________ ________________________________________
Signature of applicant Date (month/day/year)

Note: It is not necessary to print this form and sign physically. You may sign electronically by typing
your full name and the date in the spaces provided. By signing electronically, you agree to the entirety of
the certification statement on this page.