Qualtrics Survey | Qualtrics Experience Management

Student information:

First Name:

Last name:

Email:

Phone number:

School:

Current Grade Level:

Home Address:

Grade in Fall 2023:

Overall GPA:

Parent/ Guardian Information:

First Name:

Last Name:

Email:

Phone Number:

Address:

Emergency Contact Information:

First Name:

Last Name:

Email:

Phone:

Language background:

Your first language:

Your second language:

Do you speak other languages?

Have you ever learnt Arabic before? If yes describe your language abilities in speaking, listening, reading and writing?

Statement of purpose

In up to 500 words in English, please describe:
a. your hobbies and interests
b. your motivation to learn Arabic
c. your goals for enrolling in Arabic STARTALK program
d. your commitment to the three components of the program: (Pre-camp outreach activities, summer camp and post-camp outreach activities
e. future education and plans

Recommendation letter:

Teacher’s name:

Teacher’s email:

Teacher’s phone:

Food allergies

Do you have any food allergies? If yes, please list them as we will provide free lunch and snacks.