Semester/Academic Year Application

 

USU Office of Study Abroad • TSC 311

0108 Old Main Hill Logan, UT 84322-0108

435-797-0601 • studyabroad@usu.edu • www.usu.edu/studyabroad

Use this online application when applying to international exchanges through USU Partner institutions, or through ISEP. For Summer programs, you must use the USU Study Abroad Short Term Application.

By sending this application you are agreeing to have USU Office of Study Abroad charge an application fee to your ACCESS account.

*Study Abroad Program:
*For what study abroad term are you applying?:
*For what year are you applying?:
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*Banner Account ID (A#):
If you are not a USU student, please type "Non-USU Student" in the box.
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*Current admission status at Utah State University:
*Last (Family) Name:
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Middle Name/Initial:
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*First (Given) Name:
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*Birthdate:
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*Passport Number:
Write N/A if not available.
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*Passport Expiration Date:
Write N/A if no passport.
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*Passport Country of Issuance:
Write N/A if no passport.
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*Street Address:
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Apartment/Unit #:
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*City:
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*State:
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*ZIP Code:
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*Phone Number:
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Mobile Phone:
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*Email:
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*Can we share your name and email with other study abroad participants?:
Class standing at beginning of study abroad experience:
*Major:
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Minor:
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*GPA:
Please note. If your GPA is below 3.0 you may not be accepted for this program.
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*Gender:
*Citizenship:
Predominant Racial/Ethnic Group:
*Personal Statement:
Write a short statement (250 - 500 words) about your reasons for wanting to study abroad, and comment on your strengths, special interests, and educational/personal achievements. How will this program help you with your academic, career and personal goals?
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*Academic Work:
Indicate academic work in progress that would be relevant to your study abroad course work. List courses credits and grades.
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Language courses:
List language courses with credits and grades completed and/or other language experiences.
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*Requested classes for study abroad:
List classes/subjects you want to study in this program.
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*Have you ever lived, studied or traveled in another country?:
Countries experienced:
If you have lived, studied or traveled abroad list countries, dates and purpose of travel.
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Financial Resources:
Please indicate your plans for financing your study abroad experience.
*I require special needs or services, (i.e. medical):
*Medical information:
Please describe any special needs or services you will require during your exchange (i.e. medical treatments, medications, allergies, dietary consideration, learning aids, or facilities with special needs access.
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*Emergency Contact Name:
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*Emergency Contact Street Address:
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*Emergency Contact City:
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Emergency Contact ZIP Code:
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Emergency Contact Phone:
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Emergency Contact Mobile Phone:
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*Academic Referee Name (1):
The completion of this application requires two (2) academic references. Please provide the names and email addresses of persons who are willing to write an academic reference for you. Whoever you list as an academic referee will receive an automated request to complete an online recommendation.
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*Academic Referee Email Address (1):
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*Academic Referee Name (2):
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*Academic Referee Email Address (2):
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*Do you waive your right to review the contents of faculty recommendations?:
*Please attach a recent photo:
Photo must be of your head on a plain background, square, and at least 500X500 pixels.

( 2MB Filesize Limit )
Please attach a copy of your passport if available:

( 2MB Filesize Limit )
*I am in good academic standing with Utah State University or my home institution.:
*I agree to be subject to the academic and financial policies of Utah State University.:
*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 my emergency contact before, during, and after my study abroad program.:
*Please certify that all information on this application is accurate by typing your full name into the blank to the right:
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