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Please note: to be eligible for the scholarship you need to be a sophomore through senior student at the undergraduate level. The program is open solely to US citizens and permanent residents. You must have valid travel documents.

By submitting this application, you agree to be available to travel to Poland on July 1st, 2025 to attend the internship, with a return date of July 10th, 2025. You will be required to purchase an airline ticket and medical insurance for the period of the internship. 

Personal Information

Please enter N/A if not applicable

Date of Birth:
 /   / 

Your Status in the US :

Academic Information

Your current status as of Spring semester 2025:

List all institutions attended since high school
(please include all institutions starting with most recent)

In the section below, please list up to 10 most important academic
honors/ distinctions you have received. Please describe each briefly.

Extracurricular Involvement

Please fill in the following information. Lists should be in order of importance. Please enter each activitiy/achievement only once - do not duplicate information. Only information listed below will be considered by the Committee. Do NOT send any additional materials.

List membership in up to 10 Polish-American organizations, churches, Polish schools, clubs, professional associations, sports teams etc. Please note duration and time intensity of your involvement and any offices held.

Work History

List your 5 most important jobs (above 10 hours/week) or community service (above 50 hours/year) performed over the past 4 years, if not included in the information above.

Question (optional)

What additional insights or experiences would you like to share that highlight your connection to the Polish community and demonstrate your commitment to its values and cultural heritage? This could include cultural events, volounteer work, or personal initiatives.

Other

How did you learn about this scholarship? (Check all that apply):

Certification and Release Authorization

The following information must be completed for the applicant to be considered for a scholarship award.

Supporting documents

Please submit copies of the following supporting documentation (mandatory). Required documents must be submitted at the time of application. Incomplete applications will not be considered.

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