Study Abroad
Application Form
Submit completed application materials to:
UWSP International Programs
Room 108 Collins Classroom Center
2100 Main Street
Stevens Point, WI 54481
www.uwsp.edu/studyabroad
email: intlprog@uwsp.edu
Tel: 715-346-2717
OFFICE USE: __ Statement
Date:
__PAM
__ Adm
__ Transcript
__Conduct
__ Recommendations
__ Response
__ App. Fee
__ Deposit
__Leader Copy __Acpt Ltr __WL
__ MLGS
PROGRAM SELECTION
Term for which you are applying:
Fall Semester
Spring Semester
Summer
Winterim
Which year?
Where do you want to study? Refer to the current list of offerings at www.uwsp.edu/studyabroad/destinations.aspx
(If applying for an overseas internship/externship, please note that there is additional form you will need to complete.)
Program name:
STUDENT INFORMATION
Last name:
First Name:
Middle Name:
(as it appears fully on your birth certificate or passport)
Birth date:
Birthplace (city, state):
Social Security # (non-UWSP students only) :
Do you have a valid passport?
yes
no **If yes, it must be valid for 6 months
after your return to the U.S. – PLEASE ATTACH A COPY of PHOTO PAGE. If no, please
apply as soon as possible. Info at: www.travel.state.gov
Campus/Local mailing address:
City:
ZIP:
State:
Sex:
F
M
UWSP ID#:
U.S. Citizen?
Yes
No
Passport #
Campus email address:
Campus/Local phone:
Home Institution (if not UWSP)
Non-UWSP Student ID#:
Cell/Mobile Phone:
Year in college:
1st
2nd
3rd
4th
5th
Grad./Other
Home mailing address:
Cumulative GPA*
City:
ZIP:
State:
Home Phone:
*Minimum GPA Requirements: All programs have specific academic credit
and GPA requirements. Check your selected program at
www.uwsp.edu/studyabroad. If you have a concern about meeting the GPA
requirement, please contact the I.P. Associate Director or Director.
Indicate the highest course level of any foreign language you have studied:
Major field(s) of study:
Are you a:
non-student
UWSP Alumni
UWSP Employee
A UWSP Employee? List Department (and if retired):
Minor field(s) of study:
T-shirt Size:
Tuition/Residency Status:
Wisconsin
Minnesota
XS
Other State
S
M
L
XL
XXL
(Check all sources that apply)
Where did you hear about our
program?
A Past Participant in this program
The Current Program Leader
A Past Program Leader
Academic Advisor
Parents
Professor
I previously participated in (program):
SMOD
Campus Newspaper
Email from Int’l
Programs
Other Advertisement
Posters
Resource Book
Website:
New Student Orientation
Class Presentation
Campus International Programs Office
Displays on Campus
Other:
Do you have any previous international travel experience? If so, where and when?
Reasons for choosing the UWSP program?
Academics
Destination
Tours on the Program
Cost
Past Experience with UWSP Programs
Please rank 1-5 with “1” being the most compelling reason.
IN CASE OF EMERGENCY*
Primary Contact
Secondary Contact
Relationship:
Relationship:
Home Phone:
Home Phone:
Cell Phone:
Cell Phone:
*International Programs staff will contact this person in case of
emergency for the release of information during your time abroad.
NOTE: UWSP International Programs does NOT purchase cancellation insurance for individual participants. Participants are
encouraged to investigate trip cancellation insurance to determine if such insurance is in their best interest to purchase.
AUTHORIZATIONS AND REFUND POLICY
By signing this application, I authorize UWSP International Programs to perform a conduct check of my student records, to contact the
person(s) listed above in case of emergency, and to share my contact information with other program participants. I agree to pay all fees for my
program according to the payment schedule provided by UWSP International Programs and to comply with the following terms of withdrawal:
Withdrawal before the Official Program Commences.
A.
B.
C.
Up to one hundred (100) days prior to the official program start date: UWSP International Programs will retain the nonrefundable application fee and the arrangement fee. Both fees are transferable ONCE and only to another UWSP International Program
offering.
In the period from one hundred (100) days to thirty-one (31) days prior to the official program start date: UWSP
International Programs will assess penalties for any purchased or reserved transportation and accommodation arrangements as well as
any other program expenditure incurred to the date of withdrawal. Application and arrangement fees are transferable in this period as
outlined in point A.
Thirty (30) days prior to the official program start date: UWSP International Programs will assess the penalties listed in point B
and any instructional or arrangement costs that on-site providers assess UWSP International Programs. The application fee is
transferable once as outlined above, but the arrangement fee is no longer transferable.
Withdrawal during Official Program: Generally, no refund of any part of the program costs is possible.
I further agree that any outstanding payments due may be applied to my UWSP Billing Account.
________________________________________________________________________________________________
Participant Signature
Date
(Keep This Page For Your Information)
COMPLETING YOUR APPLICATION
ALL APPLICANTS MUST:
1)
Attach a single-page Statement of Commitment explaining your academic reasons as well as your personal
motives for participating in this program.
2)
Submit a faculty/university instructor recommendation. This recommendation needs to come from a faculty
member or instructor familiar with your academic performance at the university level. For foreign language
programs, this must be from a foreign language professor. The form is available at
www.uwsp.edu/studyabroad under Applications. NOTE: Instructors may also email us their recommendation.
3)
Submit the signed Academic Advisor Form for Study Abroad. Meet with your academic advisor, go over the
questions with him or her, and have your advisor sign and date the form.
4)
Submit the appropriate academic record. UWSP students need to submit a copy of their Course History,
printable from their MyPoint account (under Academics). A DPR (Degree Progress Report) is NOT an
acceptable alternative. *Non-UWSP students need to submit an official transcript from their home
institutions.
5)
Pay appropriate fee.*
UWSP Student Non-Refundable Application Fee: $50.00
Non-UWSP Student Non-Refundable Application Fee: $100.00
NOTE: A separate non-refundable $400.00 Arrangement Fee will be due at the time of your acceptance into a
specific program. Please review refund policy on page two of application or at www.uwsp.edu/studyabroad.
LONDON INTERNSHIP/EXTERNSHIP APPLICANTS: You will need to complete a separate Internship/
Externship Application with authorization signatures from your academic advisor and the internship/externship
coordinator of the appropriate department. You also need to submit a hardcopy and an electronic copy of your
résumé along with a professional cover letter. Art & Design and Interior Architecture Applicants: You may
need to submit a portfolio of your work. Please consult with Mr. Mark Koepke regarding the portfolio submissions
requirements for interns/externs.
STUDENT TEACHING ABROAD APPLICANTS: You will need the Student Teaching Abroad Application
Instructions and Authorization form signed by the SOE Director of Field Experiences and submitted with your Study
Abroad Application Form. The authorization form is available in International Programs and online at
www.uwsp.edu/studyabroad.
*International Programs does not accept credit card payments, only personal
checks and money orders. List the specific program name and term
(semester/summer/Winterim) on the check “note” or memo area with your UWSP
ID number. Make checks payable to “UWSP International Programs.”
Cash payments are possible through the Bursar’s Office. Discuss details with I.P.
Staff. Please note that all accepted applicants will receive a payment schedule.
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