Lexicon Ambassadors Program - Student Application Form

Lexicon Ambassador Program

Scholarship Application Form-
Explore the World an Make an Impact

The Lexicon Ambassador Program aims to empower high school and college students to become future changemakers through a digital global citizenship curricula, engagement with other future changemakers, and the direct feedback & guidance of an international mentor in the project country as well as a U.S. based faculty member.

Program Benefits:

*We are the only mentorship program to provide access to an online free SAT Prep Course featuring live zoom lectures with seasoned instructors as well as access to an online classroom full of prep materials and practice questions.

*Students enrolled in the leadership program have access to Academic Advising faculty who can review scholarship and college application statements. Mentorship participants can receive detailed feedback to ensure that his or her personal statement stands out.

*All learners receive personal letters of evaluation/recommendation confirming their participation which can be used for scholarship and admissions applications.

*Earn required volunteer hours to fulfill high school credit or graduation requirements through one of our online projects while making a real difference in the world.

*Courses are taught by established faculty mentors who are available to help you successfully navigate the difficult transition from high school course work to the competitive world of college and university admissions.

Application Notes
- Admission to the Lexicon Ambassador Program is based on merit, student interests, and availability of program seats
- Applications are reviewed on a rolling basis
- Admission results and scholarship offers will be sent via email.
- Multiple Scholarships for tuition with the exception of registration fees for the term.
The admissions process is competitive. If selected, you’ll receive an email offer to join the Mentorship Program, you'll be provided with a payment link and an acceptance letter confirming the program fee and deadline. Please note that admission into the program is only confirmed after payment has been received. Seats are limited and all admission decisions are final.

All fields in this form are required. (If a question is not applicable, please type in as Not Applicable or N/A.)

Program Applied For*
Students enrolled in the Leadership Track have access to live SAT lecture prep course with unlimited access to SAT practice questions and Academic Advising. Refer to our program list here: https://lexiconambassadors.com/course/#
Student’s Name*

First NameMiddle NameLast Name
Age*
Gender*
Email
example@example.com
Current Address *

Street Address

Street Address Line 2

CityState / Province

Zip CodeCountry

Present School Information
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of School*
Present Grade*

Parent Information
Father's/ Guardian Name*
School Communication should go to*
Father's or Guardian Email*
Mother's/ Guardian’s Name*
Mother’s Email*

Guardian and Emergency Contact Information
Emergency Contact
Relationship with Student
Telephone number
Email Address

Additional Information or Documents
Supporting documents, certificate of achievement, letters of recommendation (optional)

Browse Files

Cancelof
Why do you want to become a Lexicon Ambassador?*
Tell us about your Hobbies, Interests and Volunteer Experience*
Tell us why you have chosen a specific Lexicon Program to enroll in*
Would You Like To Be Considered for a Full or Partial Scholarship

YesNo
Why should we offer you the Lexicon Ambassador Scholarship?

Acceptance of Terms & Conditions and Declaration of Parents/Guardian
Declaration by Parents/Guardian

We are seeking admission for our daughter/son (hereinafter referred to as Child) in the Lexicon Ambassador Program (hereinafter referred to as the Program) after having read, understood and agreed with the terms and conditions below. We accept all terms and conditions without reservation.
1. This application has been made by us after having read and understood all the rules of the program. We declare that the information furnished by us in this application is true to the best of our knowledge and belief. We understand that the minimum age for admission is 13 years of age.
2. We fully understand that the admission to the Lexicon Ambassador Program is based on merit and on availability of a seat at the time of scrutiny of our application.
3. We understand that admission is provisional and may be cancelled should any of the statements made in this form are false.
4. We fully understand and accept that should a student join the program, the fee is required to be paid on or before the program start date. (Scholarship applicants recieve up to 100% scholarship to cover required fees.) We also understand and accept that fees once paid, shall not be refunded under any circumstances by the Lexicon Ambassador Program.
5. In the event of a fee payment being dishonoured, the Management of the Program reserves the right to dismiss/de-enroll the student at its discretion and levy any other penalty as it may deem fit.
6. We understand and accept that the Program has the right to use our student's image during instruction. We understand that parts of the program are based on Zoom conferencing and make use of the student's camera and microphone. We further understand that Zoom lectures are recorded and reposted for other students to view within the Moodle classroom.
7. We understand and accept that any student may be expelled or removed from the School for non payment of dues, for any infringement of rules of conduct.
8. We agree that the student will observe the rules relating to the Code of Conduct. The Lexicon Ambassador Program has a zero-tolerance policy for bullying or other disruptive behavior. Any student found not following the program rules will be immediately removed from the program and all tuition will be forfeited.
9. We understand that the program will require students to create study material and other content from time to time as part of the learning process and that the Lexicon Ambassador Program has the exclusive right to retain and repost those materials. We further understand that reposting of project content is necessary for the volunteer program. Content produced by students will not contain any student author indentification and is the property of the Lexicon Ambassador Program.
10. We agree that incase of withdrawal of from the program there will be no refund of program fees.
11. We fully understand and agree that no document other than those required by the program will be entertained for priority of admissions. We have read, understand, and agree to the terms of the privacy policy posted at https://lexiconambassadors.com/privacy-policy/
12. By pressing the Submit Button, we confirm the above declaration and accept the terms and conditions.
Date

DayMonthYear
Date
By checking this box, I am giving my express written consent without obligation for Lexicon Ambassadors to contact me regarding its educational programs and services using e-mail, phone, or text, including automated technology for calls and/or texts to the mobile number(s) provided. For more details, including how to opt out, read Lexicon Ambassadors' Privacy Policy at https://lexiconambassadors.com/privacy-policy/or contact us at lorrinda.khan@lexiconambassadors.com

Yes
Please ensure the following before pressing the submit button
Should be Empty:

Lexicon Ambassador Program

Present School Information

Parent Information

Guardian and Emergency Contact Information

Additional Information or Documents

Acceptance of Terms & Conditions and Declaration of Parents/Guardian