ISEP Data

*Today's Date

Please enter the date in the format MM/DD/YY

Characters remaining:

*A Number

Characters remaining:

*Last Name

Characters remaining:

*First Name

Characters remaining:

*Middle Initial

Characters remaining:

*Date of Birth

Characters remaining:

*Gender

Female Male

*Email Address

Characters remaining:

*Phone Number

Characters remaining:

*Street Address

Characters remaining:

Apartment/Unit #

Characters remaining:

*City

Characters remaining:

*State

Characters remaining:

*Zip Code

Characters remaining:

*Class Rank

*Major

Characters remaining:

Minor

Characters remaining:

Financial Resources

Parents/Family Grants Loans (FAFSA) Scholarships Personal Funds

*Medical Information

Please describe any special needs or services you will require during your exchange (i.e. medical treatments, medications, allergies, dietary considerations, learning aids, or facilities with handicapped access). If none, please enter none.

Characters remaining:

*Emergency Contact Name

Characters remaining:

*Emergency Contact Email

Characters remaining:

*Emergency Contact Phone

Characters remaining:

*Emergency Contact Street Address

Characters remaining:

Emergency Contact Address2

enter city, state, and zip

Characters remaining:

*Agreement

Enter your initials. I authorize the USU Office of Study Abroad to release my application and other information about my participation in this program to cooperating institution(s, program officials, and USU Financial Aid Office or other relevant USU departments.):

Characters remaining:

*Information Release

I authorize the Office of Study Abroad to share my email with other study abroad participants.

Yes No

Student Rights and Responsibilities

Enter Your Initials. I have read and agree to the Rights and Responsibilities on the following page: https://studyabroad.web.usu.edu/htm/outgoing-students/rights-and-responsibilities.

Characters remaining:

Predominant Racial/Ethnic Group (Optional)

Optional. For reporting purposes only.

American Indian, Alaskan Native Asian, Pacific Islander Black, non-Hispanic (African American) Hispanic, Chicano/Mexican-American Hispanic- Puerto Rico, Cuba, other Hispanic Multi-Racial White, non-Hispanic (Caucasian)

Citizenship (Optional)

Characters remaining:

*Verification : Please answer the question below

Name one of the three primary colors:

In This Section