International Programs - Application Semester and Year Long Study Abroad

Office of International Programs

Application for Semester-long and Academic Year Study Abroad Programs

Part 1: Student Information

Name*

First Name

Middle Name

Last Name

Salve ID#*

Date of Birth*

Salve Email*

Part 2: Program Choice

Please note that program options will be confirmed at the beginning of the fall semester.

Choice 1: Semester You Are Applying For*

Program Choice 1*

Choice 2: Semester You Are Applying For:

Program Choice 2

Part 3: Demographic Information

Gender*

Race*

Ethnicity/Race (optional)

Upload a Headshot of yourself*

No File Chosen

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Image will be used for student identification

Part 4: Academic Information:

Have you already studied abroad through Salve Regina University?*

Yes No

If yes, provide the program information

When and which program

Anticipated Graduation Date*

Cumulative GPA*

Please Note: You must have a minimum 2.7 cumulative GPA to be approved for study abroad through Salve Regina University.

GPA 2.7 or above?*

Yes No - Contact the Office of International Programs to discuss the appeals and waiver process

Pell*

Yes No

Major 1*

Major 2

Minor 1

Minor 2

Have you officially declared your major (?) and/or minor(s)?*

Yes No

If you have not offcially declared your major or minor, stop now. You must be offcially declared in order to continue this application.

Please list the Salve courses you hope to fulfill abroad*

EX: Lit Core, MGT 212, Psych Elective, PHL Core...

Part 4: Passport Information

Please Note: You cannot study abroad without a valid passport. Your passport must be valid for at least 6 months after your scheduled program return date. The process to obtain a new or renewed passport can take 6-8 weeks.

Do you have a passport valid at least 6 months after your scheduled program return date? *

Yes No- Please apply for your passport as soon as possible

If no, have you already applied for a new passport or to renew your passport?

Yes No

If yes, upload a copy of the photo and signature page from your passport and complete the following information.

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Part 5: Contact Infomation

Please notify the Office of International Programs of any address or phone number changes so we can easily contact you.

Local Address During School: Residence hall/ off-campus*

Address Line 1

Address Line 2

City

State

ZIP Code

Personal Email*

Non-Salve email address

Primary Phone*

Alternate Phone

Permanent Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Part 6: Emergency Contact Information

Please Note: Program information and Participation Agreement for Parents/Legal Guardians form will be sent to your primary emergency contact.

Primary Contact Name*

First Name

Last Name

Relationship*

Primary Phone*

Alternate Phone

Email*

Secondary Contact Name*

First Name

Last Name

Relationship*

Primary Phone*

Alternate Phone

Email*

Part 7: Special Considerations

Please Note: If you believe you may need services or accommodations during your study abroad due to a medical condition or other disability it is important that you disclose to us particulars of your situation so we can assist you in making necessary arrangements. If you have a medical condition, disability, or special need, we strongly encourage you to discuss your needs with your study abroad advisor, doctors, counselors or the Academic Development Center (401-341-2226) if applicable.

Do you have any allergies, disabilities (visible or non-visible), dietary preferences, medical conditions or other special needs you would like us to be aware of?

Yes No

If yes, please describe below

Part 8: Goal Statement

Please attach a 500 - 750 word statement explaining why you would like to participate on the semester study abroad program for which you are applying. Why did you select the program for which you are applying? What impact will your choice of country have on your experience abroad? What goals do you hope to accomplish academically, personally and professionally while abroad? Are there unique components, such as home-stays, that will impact your experience abroad? What challenges might you face while abroad, and how do you plan to tackle these challenges?

Goal Statement*

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Part 9: Faculty References

Please ask two Salve faculty/staff members (one MUST be Salve Faculty, the other can be Salve Faculty or Staff) to complete the attached faculty reference forms and submit the completed forms to the Office of International Programs via campus mail, fax (401-341-2972), or email (studyabroad@salve.edu). Indicate below who you have asked to provide your references in case we need to follow up with the faculty member.

Download the faculty reference form

Reference Name 1*

First Name

Last Name

Department*

Reference Name 2*

First Name

Last Name

Department*

Part 10: Resume

Please upload a copy of your most recent resume. Make sure that it is proofread.

Resume*

No File Chosen

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Part 11: Signature

By submitting this application, I certify that the information on this application is correct. I acknowledge that acceptance into the program is subject to certain eligibility requirements and is at the discretion of Salve Regina University. I understand my financial aid package in regards to study abroad. I understand that students on study abroad programs must comply with the Student Code of Conduct and any other applicable rules, as well as with the laws of the host country. I acknowledge and agree that Salve Regina may revoke my acceptance or withdraw me from the Program at any time if:

I am no longer a matriculating student at Salve Regina,
I no longer meet eligibility requirements of the Study Abroad Program,
I fail to pay Salve Regina tuition for the semester abroad, the required study abroad fee and all Program fees,
I fail to comply with all requirements of the Program including requirements pertaining to visas, participation agreements and releases, and vaccinations, or
I have been found to have violated the Student Code of Conduct or any other law, rule, or regulation and/or I have engaged in unprofessional and/or inappropriate behavior that would affect my ability to preserve the high standards of the University as a student studying abroad.

I also authorize Salve Regina to publish for public relations purposes my photograph or photographs in which I appear.

Applicant Signature*

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Date Signed*

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