Foreign Study Program - Application Form
Foreign study program/country:_________________________________________________________
How did you hear about this program?__Poster__TV__Ledger Ad__In-Class__Other________________
Completed applications will contain the following materials:
Signed and completed Application Form with payment of $250 attached
Two typewritten short essays that answer the questions provided below
A current unofficial transcript (available at: http://MyUW.washington.edu; please choose the
“printer-friendly version” for unofficial transcripts)
ALSO, ask two UW instructors who know your academic work to fill out the survey found at:
https://catalyst.uw.edu/webq/survey/tvnorris/130605. Be sure to tell the instructors which
country/program you are applying for.
Name (as on passport):_____________________________________ Student #:___________________
Gender:
male / female
Birth date:_____/_____/_____ Local phone: (_____)______-__________
Email:____________________________Concentration/major(s):_______________________________
UW status:
Never before attended
Undergraduate
Graduate
Non-matriculated
Current Class Standing: FR / SO / JR / SR Expected to graduate (Qtr/Year)_______/________
Passport #: _______________ Exp. date:______/_____/______ Country of citizenship:_____________
(If you do not have a passport, you should apply for one immediately upon acceptance to the program.
It is your responsibility to obtain a passport prior to program departure: travel.state.gov/passport )
Emergency contact name while abroad: _________________________________________________
Relationship:___________________________________ Emergency phone: (_____)______-_________
Emergency email: ____________________________________________________________________
Have you travelled outside the U.S. before? ___yes ___no
If yes, please list where and when?
____________________________________________________________________________________
____________________________________________________________________________________
How will you finance the program?_______________________________________________________
____________________________________________________________________________________
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Essays: Write a short essay on 2 of the following 3 topics, each on a separate page (one-half to one
page each):
1. Please explain why this particular program is a good fit for you; how will this program
contribute to your academic and/or personal goals?
2. Describe a way that another culture has influenced you.
3. Describe any courses or experiences you’ve had that you think would enhance your learning
experience in this course (e.g., research experience, science or sustainability coursework,
Spanish skills). Describe each in detail.
Names & phone extensions of the two UW Instructors you have asked to fill out the reference survey:
_____________________________ext. #______
_____________________________ext. #_____
Participant Declaration:
I have read the information about the program and travel requirements. I understand all the conditions
under which the program will be operated, including those that apply to payment and refund
conditions for the program.
__________________________________________
______________________
Participant’s signature
Date
(Legal Guardian if participant is under 18 years of age)
Completed applications should be submitted to the Office of International Programs (OIP). All
attachments should be double-sided (please use as little paper as possible). Materials can be either
submitted in person to GWP 312, or mailed to the following address:
Office of International Programs (#358430)
University of Washington Tacoma
1900 Commerce Street,
Tacoma, WA 98402
Fax: 253.692.5643 Phone: 253.692.4426
An administrative fee of $250 is due at time of application. Personal checks, cashier’s checks, or
money orders made payable to University of Washington Tacoma (UWT) are accepted. Please write the
country/quarter/year of the program in the memo line (i.e. Kenya/Winter/2012). If you cannot pay in
person or mail your check, please contact Tracey Norris at 253-692-4426 or [email protected] for other
payment options. Please note: Applications received without payment will not be considered.
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Please read and sign the Code of Conduct and Terms of Participation below.
Code of Conduct for Office of International Programs (OIP)
The Office of International Programs expects each foreign study opportunity to be uniquely educational
and a positively transformative experience for each participant. Participants have responsibilities to their hosts
as representatives of the University of Washington and to engage in appropriate conduct. As such, the Office of
International Programs maintains this code of conduct:
• A participant is expected to be engaged in all academic aspects of the program, including (but not
limited to) punctual attendance to classes, completion of assignments, and participation in class
discussions.
• A participant is expected to take part in required group activities, including (but not limited to) group
meetings, projects, field trips and service learning engagements.
• Threatening or demeaning conduct is prohibited.
• A participant is expected to abide by the University of Washington’s policy prohibiting sexual
harassment.
• A participant is expected to obey the laws of the host country, and the rules of host institutions
(dormitories, classrooms, workplaces etc.).
• Conduct which threatens the viability of future UW foreign study programs in the host country is
prohibited.
• Participants are expected to comply with the University of Washington Student Conduct Code
(available online at http://www.tacoma.washington.edu/studentaffairs/SS/conduct_code.cfm).
Participants who fail to observe this code of conduct may be dismissed from the program.
Terms of Program Participation for the Office of International Programs (OIP):
If you are accepted to this program, you will be notified by e-mail. You will be given additional documents to
complete. Upon receipt of the completed additional documents and first program payment, OIP will register you
for T INTL 300 (or 500 depending on program level) and any remaining program fees will be assessed to your
MyUW student account for payment. You are responsible for all program expenses.
Travel Insurance: Study abroad insurance coverage is required. We recommend UW students take advantage of
the UW Study Abroad Insurance, as an easy and affordable option. Students with personal travel insurance may
petition for a UW Study Abroad Insurance waiver. Contact OIP for details.
Withdrawal: Once you have confirmed participation, you cannot be removed from the program roster unless
you submit a letter of withdrawal to OIP. Refer to your program’s details for information on their refund policy.
I have read and understood the Code of Conduct and the Terms of Participation, and I accept these terms.
_______________________________________________________ ____________________________________
Participant Signature (or Legal Guardian if under 18 years of age)
Date
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