Kennedy-Lugar Youth Exchange and Study (K-L YES) Program

Preliminary Application 2016 - 2017

Name of School: __________________________________________________________________________________________

PARTICULARS OF SCHOOL:

Address: ________________________________________________________________________________________________

___________________ City: ________________ Province: _______________ Telephone with city code: __________________

Name: _______________________________________________________________________________

PARTICULARS OF STUDENT:

Date of Birth: ____________________ Place of Birth: ________________ Province:_________________ Gender: Male Female Nationality: _______________ Religion: _____________________ Residential Address: ___________________________________________________________________

______________________________________________________ Province_____________________

Phone Number: _____________________________ Mobile Number: _______________________________________________

Student’s e-mail Address: ______________________________ Class in which studying at present: _______________________ Classes studied in: 2014-2015 Class: _______________________________ Percentage: ___________________________

2013-2014 Class: _______________________________ Percentage: ___________________________

2012-2013 Class: _______________________________ Percentage: ___________________________ Have you participated /Are you participating in English Access Microscholarship Program? YES NO

If ‘Yes” write the name of Access Centre and city: __________________________________ Year _______________________

Access Centre Address: ____________________________________________________________________________________

Have you ever visited USA? YES No If ‘Yes’, When & Where_______________________________________

Have you or your family applied for US immigration? YES NO

Have you or your family applied for immigration to any other country? YES NO

If ‘Yes’, what is the name of that country? _____________________________________________________________________

Has your sibling (brother or sister) been on K-L YES Program? YES NO

If ‘Yes’ what is his/her name? ________________________________Year Participated: ________________________________

Father’s Name: ________________________________________________________________________________________

PARENTS’ INFORMATION:

Father’s Occupation: ___________________________________ Designation/Position: ______________________________

Organization / Nature of Business: ________________________________________________________________________

Complete Work / Business Address: _______________________________________________________________________

Office Telephone No: ____________________________________________ Cell No: _______________________________

Mother’s Name: _______________________________________________________________________________________

Mother’s Occupation: __________________________________ Designation/Position: ______________________________

Organization / Nature of Business: ________________________________________________________________________

Complete Work / Business Address: _______________________________________________________________________

Office Telephone No: ____________________________________________ Cell No: _______________________________

Recent

Photograph (Taken within the

last 6 months)

Kennedy-Lugar Youth Exchange and Study (K-L YES) Program

Guardian’s Name: _______________________________________ Relationship to you: ____________________________

GUARDIAN’S INFORMATION (if any):

Guardian’s Occupation: __________________________________ Designation/Position: ___________________________

Organization / Nature of Business: _______________________________________________________________________

Complete Work / Business Address: ______________________________________________________________________

Office Telephone No: ____________________________________________ Cell No: ______________________________

_________________________ __________________________ ________________________ Student’s Signature Parent’s / Guardian’s Signature Signature and Seal of School Principal

DOCUMENTS REQUIRED

• Attach Photocopy of NADRA ‘BAY’ form or NADRA Birth Certificate. (No other document will be accepted other than NADRA)

• Attach photocopies of the marks sheets of the last 3 years. All marks sheets should be attested by the school principal.

Last date for submission of Preliminary Application is 15 September, 2015.

NOTE:

•

Application received without complete required documents WILL NOT be considered. Providing any false/forged

documents or information at any stage of selection process will result in disqualification of the applicant.

•

Applicant can submit only one form of application, either online or hard copy. If they submit applications in both forms (online and hard copy) their applications will not be accepted for further processing.

Completed applications can be submitted to school and the school can send them to iEARN Centre, Karachi or

students can send their applications directly to iEARN Centre.

iEARN CENTRE

88-H, P.E.C.H.S, Block-6, Karachi-75400, Pakistan. Phone: 0333-3661131

• Write K-L YES 2016 – 2017 on the top of the envelope.

• Make sure you provide all correct and accurate information. If anything is found incorrect after verification the application will not be accepted.

• This is not the application form; the complete application form will be issued after the clearance of the English language proficiency test and final interview.

• The acceptance of this form does not ensure the acceptance in the K-L YES program.

• Visit the web www.yespk.org for detailed information and updates.

• Hand delivered applications will not be accepted.

Kennedy-Lugar Youth Exchange and Study (K-L YES) Program

K-L YES ELIGIBILITY CRITERIA

Students who meet the following criteria can apply using the online Preliminary Applications or get a printout from the website and send filled applications to iEARN Center, Karachi. • Be a citizen of Pakistan.

• Secondary school students in their home country (Pakistan) who are currently enrolled in 8th, 9th or 10th grade or O Level students. Preferably students who have taken or will appear in grade 9th, 10th

, or 'O' Levels examinations by August 1, 2016 and waiting for results.

• Minimum 15 years of age but not more than 17 years on August 1, 2016.

• Minimum grade "A" (70%) in all major/core subjects (English, Mathematics, Sciences) in the last class attended; overall minimum ‘A’ average (70%) for the past three years.

• Can communicate in English. Minimum 70% in the last English exam (2014-15 and minimum B (60%) in previous two years (2012-13 and 2013-14).

• Must not have traveled to the United States. Note: Minimum 70% in all subjects in the last examination before departure to the U.S.A. (The annual exams that will be held in 2016). Students will be required to send the mark sheets of the last examination when they receive the mark sheets. Students who meet the following in addition to the above criteria are likely to be short listed for the final competitions.

• Should pass English Language Proficiency test.

• Know and practice Pakistani culture and values, and able to represent the same in U.S schools and communities.

• Demonstrate maturity, flexibility, adaptability, good character and scholastic aptitude.

• Willingness to participate in host family’s daily life.

• Record of all necessary immunizations, as outlined in the Student Application, before arriving in the U.S.

• Should demonstrate flexibility and a commitment to promoting cross-cultural understanding.

• Agreement to attend classes as a full-time student and maintain at least a ‘B’ Grade average in an American high school.

• Willingness and agreement to abide by the 'K-L YES Student Rules' as outlined in the K-L YES Student Application and all other rules and policies during the program.

• Siblings should not have been on the YES program.

• Meet U.S. J-1 visa eligibility requirements (for instance, U.S. citizens are not eligible for J-1 visa)

Application and Selection Process for 2016 – 2017 Students who fulfill the Selection Criteria and agree to the Parent Student Agreement and General Program Rules (Please visit the website www.yespk.org ), can apply for the scholarship. Female students, students with physical disabilities and students from non-elite and government schools who meet the criteria are strongly encouraged to apply.

Students who are eligible according to the Selection Criteria but their schools are not interested in participating in the K-L YES program can apply independently. They can download the Preliminary Application Form from the K-L YES website and submit via courier or mail along with all the required documents. Please do not send any original documents. We do not return any documents submitted. Only send the photocopies of the documents mentioned in the Preliminary Application.

The participating schools/organizations must collect fully completed applications with all required documents from students and submit the applications and required documents to the iEARN office.

After the initial application evaluation, the short listed candidates will be invited to take the English language proficiency test. English language proficiency test will be organized in some of the major cities of Pakistan. Keep checking the announcement section of the iEARN Pakistan website for updates and information for test dates.

Students who pass the English language proficiency test would be short listed and interviewed by an ‘Interview Committee’.

Students who qualify the interviews will be asked to complete and submit the final K-L YES application along with the signed program agreement and valid passport. After the final review and evaluation of the applications, the students who are selected as YES finalists will be notified by a letter from the YES Program Director.

The students selected finally would be enrolled in a compulsory ‘Pre Departure Orientation’ program prior to traveling to the U.S.A.

88-H, P.E.C.H.S, Block-6, Karachi-75400, Sindh, Pakistan. iEARN Centre

Phone: 0333-3661131 E-mail: info@yespk.org Web: www.yespk.org