Last Name: First: Middle:
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Date of Birth: Male Female
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Ethnic Group: Black/Non-Hispanic White/Non-Hispanic Hispanic
American Indian/Alaskan American Alaskan/Pacific Islander Race Unknown
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How did you hear of UHV's Global Proficiency Certificate: -Please Select- Internet Our Catalog/Brochure Electronic Mail Mail My School A Recommendation A Representative Other
Undergraduate Graduate Expected Date of Graduation: Month Year
Degree:
Language Study: any (1) of the following
• A 202 or higher course in -Please Select- Arabic Chinesee Hebrew Japanese Korean Russian
Where was above course taken
• A 300 or higher course in -Please Select- French German Italian Spanish
• Documentation needed of intermediate proficiency in any foreign language • Students who are pursuing the “UHV Spanish for Professionals” certificate will upon completion of the certificate have fulfilled the Language Study requirement
Two or more upper division three semester credit hour courses which are specifically “internationalized” are required. Courses must be approved by Global Proficiency program coordinator and/ or your degree plan counselor. Courses approved will change and grow based on faculty recommendations and petitions
Course 1:
Course 2:
Global Activities and Experience: Students are required to attain points from International experience and one other area. Students are encouraged to attain points from all three areas. A minimum of 50 points is required, and students work with coordinators to complete the checklist of Global experience requirements: Describe International experience: • Study abroad: 30 points for the semester, 10 to 25 points for short-term (based on hours per week). The Study Abroad Office will help participants with planning and financing their international experience. International/multicultural internship: 30 points for the semester, 10 to 25 points for short-term (based on hours per week).
Describe Cross cultural community/campus experience:• Internship with an organization that works with diversity and cross-cultural issues or a volunteer position with a cross-cultural community event. 2 to 30 points (based on event or hours per week). Cross-cultural and or diversity training/workshops: 5 points per training or workshop. 30 points for a semester course on this topic.
Describe Campus experiences:• International/multicultural clubs: 2 points for member per semester, 5 points per semester for officer. Maximum of 15 points. International Classroom: 5 points per presentation. Maximum of 10 points. Language Partner Program: (ESL, Tutorial, Academic Center, etc.) 5 points per semester. Maximum of 10 points. Attending international or cross-cultural events, lectures, performances on any UHV campus or in the community: (See IP Coordinator to determine what events apply.) A written summary (minimum 3 paragraphs) of the event is required for your portfolio. 2 points per event. Maximum of 20 points. *Note: participants may include prior documentable experiences not completed at UHV
Portfolio Project: (2 points) (Mandatory) Students must develop a reflective essay and presentation that integrates their work and experiences in the international arena. Creating a portfolio essay and presentation helps students reflect on their cross-cultural development and hone important professional skills during their final year at UHV. Portfolios contain important information and resources to show to perspective employers, and provide talking points for interviewing.
I hereby affirm that to the best of my knowledge all information furnished on this form is complete and accurate. I understand that withholding information requested and/or giving false information may make me ineligible for admission and enrollment. I agree that a record of my academic performance may be furnished by all institutions of higher learning that I have attended. I am eligible to return to the last college that I attended.
Name:
Date:___________________ Applicant's Signature_____________________________________