PHOTO
Universidad San Ignacio de
Loyola
Av. La Fontana 550, La
Molina
Telf. (511) 317-1000 ext 3220
Fax. (511) 317 1059
www.usil.edu.pe
Application for Admission
Family name
First name
Given names according to passport:
Number of Passport
Date and place of birth Day
Month
Year
Nationality
Sex:
Male
Female
Double click on the square of your answer and activate it. Check (x) if printed.
Address
City
Country
Zip Code
Telephone
E-mail
Home Institution
School/Academic Program/Major
Address
City
Country
Exchange contact
Telephone
Zip Code
E-mail
Arrival Date:
Closer Peruvian Consulate for the student: Country
City
Signature ___________________
Date
Notice: Students must enter to Peru under a TOURIST VISA if coming independently or through an educational
representative. If students come through a partner university of USIL, they must enter to Peru under an
OFFICIAL VISA, which is requested by USIL to migrations office, then sent to the consulate you indicate above.
Please do not get a student visa on your own.
Study Abroad Academic Planning Form
Student’s Name
Program: (Double click on the square of your answer and activate it. Check (x) if printed)
Semester in Cusco
Summer in Cusco
Faculty-led
Other program
Name of other program:
Term abroad: (Double click on the square of your answer and activate it. Check (x) if printed)
January - May
August - December
Summer term (May)
Dates of the program: From
Summer term (July)
Other term
to
For exchange/study abroad student:
Study Program in your Home Institution
Field of study:
Number of years studied prior to departure:
Courses (Double click on the square of your answer and activate it. Check (x) if printed)
For the Semester in Cusco, students are allowed to register up to five courses. For the Summer in Cusco, students
are allowed to register only in two courses.
Beginning Spanish*
Pre-Intermediate Spanish*
Intermediate Spanish*
Advanced Spanish*
History of the Inca Civilization
Contemporary Society and Culture of Peru
Biodiversity of Peru
Inca Architecture
Art & Design in Cusco
Photography
Quechua
Business in Peru and Latin America
Communications Psychology
Andean Nutrition
Latin American Literature (taught in Spanish at an advanced level)
Institutions in Peruvian Society (only IPSL students)
Other course(s):
* Level to be determined upon results of Spanish Placement Test administered by USIL
Language Skills (Double click on the square of your answer and activate it. Check (x) if printed)
Spanish
English
Beginning Intermediate Advanced Beginning Intermediate Advanced
Speaking
Reading
Writing
Listening
Other language skills:
French
German
Dutch
Danish
Norwegian
Swedish
Japanese
Portuguese
Chinese
Others
Accommodations: (Double click on the square of your answer and activate it. Check (x) if printed)
USIL Residence
Family homestay
Hotel / Hostel
Independent accommodations
Attention: This form cannot be processed without photos and a clear passport copy. If you do
not enclose them, you will not receive your student card in time.
I hereby confirm that the information I have given is correct and may be used for administrative
purposes at the university abroad to which I have applied for exchange.
City and date
Signature
_____________________________
How did you hear about USIL?
An article in a magazine or newspaper/ USIL brochure
A current or former student at my home university
Internet
At an education fair
An educational representative agency
School advisor/International Office
USIL web site
Other:
Enclose:
1. Four (4) passport photos
2. Curriculum Vitae and Motivation Letter (English or Spanish)
3. Transcripts and grade reports (English or Spanish). Students must have a minimum GPA of 2.7
or equivalent to be eligible for the program.
4. Enrollment letter from the University (English or Spanish)
5. Clear passport copy (valid for the entire period of stay in Peru)
6. Copy of International Health Insurance valid for the entire period of stay in Peru