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George J. Mitchell Scholarship
George J. Mitchell Scholarship
George J. Mitchell Scholarship
Application for 2018/19 Academic Year
PART A: GENERAL INFORMATION
This form allows you to work on your application for a 30-day period. You can complete and save sections of the form without submitting them and then return to complete the form and upload files at a later date. If you have questions about any items in this application, contact Karen Hamilton at khamilton@mccs.me.edu.
Name
*
First
Last
Home Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Address at College
Same as previous
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Preferred Phone Number
*
Preferred Email
*
Enter Email
Confirm Email
Birth Date
Month
Day
Year
Emergency Contact Name
*
First
Last
Emergency Contact Phone Number
*
Relationship of emergency contact to you
*
Do you have health insurance?
*
Having health insurance is a requirement of the exchange.
Yes
No
Do you have a valid passport?
*
You must have a passport valid for at least six months beyond your expected return to the United States.
Yes
No
Are you a US Citizen?
*
Yes
No
If no, of what country are you a citizen?
Have you traveled outside the United States?
*
Yes
No
If yes, where? For how long?
If you are selected, list your name as you would like it to appear on the award certificate.
*
The Irish Naturalisation and Immigration Service requires that student visa holders must have proof of sufficient funds to support themselves financially during their period of study in Ireland. The living stipend that is awarded as part of the Mitchell Scholarship provides all but approximately $600 of the funds that Irish Immigration requires to be deposited in a bank account on the day you register with the Immigration Service (after your arrival in Ireland). Once registered, no additional proof of funds is required. If selected for the Scholarship, will you be able to comply with this requirement?
Yes
No
PART B: EDUCATIONAL STATUS
If you are a current community college student, answer the next four questions.
I am enrolled as a full-time student at (choose from drop down menu):
Central Maine Community College
Eastern Maine Community College
Kennebec Valley Community College
Northern Maine Community College
Southern Maine Community College
Washington County Community College
York County Community College
Not Applicable
I plan to graduate in (month/year)
I will have an associate degree in (program of study)
Current GPA
If you are a community college graduate, answer the next four questions.
Which college did you graduate from? (Choose from drop down menu.)
Central Maine Community College
Eastern Maine Community College
Kennebec Valley Community College
Northern Maine Community College
Southern Maine Community College
Washington County Community College
York County Community College
Not Applicable
I graduated in (month/year)
I have an associate degree in (program of study)
Final GPA
PART C: REFERENCES
Your application must include two letters of recommendation. At least one writer should be affiliated with the Maine Community College System and be familiar with your academic ability. At least one writer should recommend you for community service. In addition, we ask that references speak to your maturity, leadership abilities, and readiness to travel and live abroad independently. Reference letters should include the writer's name, contact information, and how long and in what context he or she has known you. List below the individuals who will write a letter of recommendation for you.
First Reference Name
*
First
Last
Second Reference Name
*
First
Last
PART D: SIGNATURE
By writing my name and the date below, I certify that the information presented in this application is true and complete.
Name/Date
*
PART E: ATTACHMENTS AND CHECKLIST
In addition to completing parts A-D of the application form, the following information must accompany your application. All parts of your application must be received at the Maine Community College System by March 15, 2018. Please note: Uploaded files are not saved if you choose to save a draft of this application and complete it at a later date. Upload files to the form when you are ready to submit your completed application. All uploaded files must be in Word, PDF, or PNG format.
I. List of Course(s)
Review the courses offered at Cork Institute of Technology at http://courses.cit.ie. Courses at CIT equate to community college programs of study; CIT modules equal our courses. List here one or more courses that interest you and any module of particular interest. Include a brief statement explaining why.
II. Essay
Attach a document (Word, PDF, or PNG format) that describes in 500 words or less why you should be awarded the George J. Mitchell Peace Scholarship. Include 1) your name; 2) how this exchange with Ireland will benefit you personally; 3) how it will contribute to your education or career plans; 4) why and how you feel prepared to live and study in another culture—particularly in Ireland; and 5) how you will use this experience to benefit others through leadership and community service.
Max. file size: 50 MB.
III. Resume
Attach your resume. (Word, PDF, or PNG format) It must be complete and up-to-date.
Max. file size: 50 MB.
IV. Community Service
List the professional, community, or school activities/organizations you are participating in now or have in the past. Include any offices held.
V. Official Community College Transcript
Upload your transcript here, or have the college send it directly to khamilton@mccs.me.edu for arrival by March 15, 2018. Uploaded files must be in Word, PDF, or PNG format.
Max. file size: 50 MB.
VI. Two Letters of Recommendation
Upload them here or recommenders may email them separately to khamilton@mccs.me.edu for arrival by March 15, 2018. Uploaded files must be in Word, PDF, or PNG format.
Max. file size: 50 MB.
File
Max. file size: 50 MB.
Name
This field is for validation purposes and should be left unchanged.
Δ
More About the Mitchell Exchange
Overview
Application & instructions