Home : USU Study Abroad Forms : Incoming Student Application

Incoming Student Application

INSTRUCTIONS FOR EXCHANGE STUDENTS:

Complete the online application.

Print and complete all pages of J-1 Student Visa Forms below

Mail completed J1 student visa forms, original financial support documents, and your official transcript (translated in English). These documents should be sent to our office through your home institution coordinator along with one (1) academic reference letter or an introduction letter from your home university exchange coordinator.

J1 STUDENT VISA FORMS

Term Applying For

Please select the study abroad term you are applying for.

Academic Year (Fall and Spring) 2012-2013 Fall 2012 only Spring 2013 only

Application is for Undergraduate or Graduate studies

Undergraduate Graduate

*Family Name

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*First Name

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Middle Name

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*Address

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*City

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State/Province

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*Country

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Postal Code

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*Phone

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*Email

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*Passport Number

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*Country of Citizenship

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*City and Country of Birth

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*Birthdate

MM/DD/YYYY

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Home Institution

Please type the name of your home university

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*Name of your home institution's exchange coordinator

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*Email address of your home institution's exchange coordinator

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*Requesting Placement As

Graduate Undergraduate

Major

Please type your major/field of study at your home institution

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*Area of Study

Please type the area of study/major you wish to take during your study abroad term (i.e. business, engineering, biology, English language, humanities,etc)

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List the courses that you would like to take while at USU:

All courses should be in a single line indicating: Title of Course - Credits - Course # - Instructor (For a description of courses offered, please go to http://www.usu.edu/ats/generalcatalog/. For a list of courses offered for the semester(s) that you plan to attend, please go to http://www.usu.edu/registrar/catalogpdf/ and pick the catalog for the semester that you are planning on attending.

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*List the courses you have taken that would help prepare you for your program of Study Abroad at Utah State University

All courses should be on a single line indicating: Title of Course - Credits - Grade - Semester/Year

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*Emergency Contact Name

Person to contact in case of emergency (Parent, Spouse, Guardian preferred) to whom USU may release information regarding your Study Abroad participation before, during and after the program.

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*Emergency Contact Relationship

How is your emergency contact related to you?

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*Emergency Contact Street Address

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*Emergency Contact Street City

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*Emergency Contact Country

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*Emergency Contact Phone (Day)

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*Emergency Contact Phone (Evening)

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*Can we share your name and email with other potential participants in international Study Abroad activities?

no yes

*Would you like to participate in the USU Study Abroad Buddy Program?

The buddy program pairs you with a USU Student for activities.

no yes

*I will require special needs or services during my exchange

If you indicate (i.e., medical treatments, medications, medical or food allergies, dietary considerations, learning aids, or facilities with handicapped access) please give specific information below.

no yes

If you answered yes to the "Special Medical Needs" question above, please describe needs

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*Type your initials to indicate that you agree to purchase USU health insurance or show proof of adequate medical insurance upon arrival for the duration of your exchange

Your initials indicate that you understand that this insurance must meet the conditions outlined by U.S. Department of State. Failure to meet these requirements will result in your termination from the Exchange Visitor Program and my right to stay in the United States.

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*Have you ever lived, studied or traveled in another country?

no yes

If you answered yes to the "lived/studied in another country" question above, please describe and include dates

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*In the space below please include a one-page typed statement describing how this program will meet your academic and professional goals.

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Please attach a scanned copy of your passport

*Do you certify that statements made on this Study Abroad application in its entirety are true and accurate.

no yes

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