Print in pdf.

Crossing Borders/Breaking Boundaries
Application Form

Deadline: May 20, 2005

There is a non-refundable application fee of $30 per applicant. Checks must be made payable to University of Maryland. Memo section of check should say ARTS INSTITUTE. If you have questions, please call the Center at 301-405-6832.

Please check one: ____ INDIVIDUAL application _____ TEAM application

If you are applying as a team, each member must supply a complete application and statement of purpose. Teams must submit all application materials by mail in a single envelope.

Name: ______________________________ Social Security Number: ___________________

Home Address:_____________________________________________________________

________________________________________________________________

Home phone: ________________________ E-mail: ________________________________

Emergency Contact: ________________________________ Phone: ___________________

School Address: ____________________________________________________________

___________________________________ County: ____________________

School phone: _______________________ School fax: _____________________________

Discipline: Dance ____ Music ____ Theater ____ Visual Arts ____ Other ______________
(Please specify)

Currently teaching grade(s): _______________ Years in teaching profession:___________

I understand that I must reside on campus July 18-21

Initial __________

I understand that I must attend all scheduled activities,
including weekend and follow-up events

Initial __________

I would like to secure weekend housing for July 22-24

Initial __________

Statement of Purpose for All Applicants

All applicants must provide a two-paragraph response to the following question in order to be considered for admission to the program. Please type or word-process your response on a separate sheet of paper.

How might an exploration of the exchanges between Europe and Arabia, 1450-1750, make its way into the curriculum you are currently teaching?

Send completed applications to:

Crossing Borders/Breaking Boundaries
Center for Renaissance & Baroque Studies
0139 Taliaferro Hall
University of Maryland
College Park, MD 20742

Phone: 301-405-6830
Email: crbs[at]umd.edu
Fax: 301-405-0956

www.crbs.umd.edu/crossingborders

Crossing Borders/Breaking Boundaries does not discriminate on the basis of race, color, sex, age, national origin, or disability in matters affecting eligibility or providing access to programs. Please inform us if you require adapted housing to accommodate any mobility impairment or other disability.