UW Summer High School Institute Scholar Application Form
The Institute values diversity and demonstrates this through the curriculum and activities of the program. We encourage and welcome students from ethnic minority populations, students with disabilities, and any qualified applicant who will enrich our program and the experience of all who participate.
First Name:
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Last Name:
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Student Phone Number (We may need to call if we have follow-up questions about your application)
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Your Email Address (please note: this email address will be used to send out notification of acceptance. This must be an account you check often. However, please DO NOT use your school email as we are not able to send emails to these accounts.)
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example@example.com
Name of Parent or Legal Guardian
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First Name
Last Name
Parent/Guardian Phone number
Parent/Guardian Email Address (we will be copying your parents in on your notification of acceptance)
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Shipping Address (We will be mailing forms and letters to this address if accepted)
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birthday
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Month
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Day
Year
Date
Sex
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Female
Male
Your chosen pronouns
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School you are Currently Attending
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School District
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Personal Statement:
You are required to submit a personal statement answering the following questions: Why do you want to participate in HSI? How can this experience help you in your future endeavors? Describe a time you faced adversity and what the outcome of that situation was. Tell us about an experience that impacted your life and how it changed the way you live your life.
You have two options for the Personal Statement: one is to write an essay of a minimum of 300 words; the other is to create a short video (no more than 4 minutes in length). If you go with the video, please provide a link to your submission via YouTube, Vimeo, or a shared cloud drive.***Please note: Submitting a video Personal Statement helps the applicant stand out during the review process.***
Personal Statement type:
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Please Select
Essay
Video
Please Upload your HSI Personal Statement below:
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Please provide link to your video via YouTube, Vimeo, or a shared cloud drive.
Please upload your Awards & Achievements document below (this document should let us know if you have won any awards or any extra-curricular engagements you are part of). Please have your Awards & Achievements complied into one document. Do not submit multiple pictures or documents.
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If we were going to ask your friends to describe who you are, what are three things they would say about you?
What are three words/short phrases that you would use to describe yourself?
What do you do for fun?
Student Signature------By signing my name below, I submit my materials for review and will attend the entire 3-week (July 6-26, 2025) program if accepted.
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Parent/guardian signature -----By signing my name below, I acknowledge my student must commit to attend the entire length of the program.)
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Submit
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