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Study Abroad Application
1. Applicant Information
Last Name*
First Name*
Date of Birth*

MonthDayYear
Date
Mobile Phone Number

Area CodePhone Number
Home Phone Number

Area CodePhone Number
Address*
City*
State*
Zip*
Current Housing Status:*

ResidentCommuterOff-Campus Housing
DSU E-mail*
Other E-mail
Citizenship
Major*
Approximate GPA
Class Year:*

FreshmanSophomoreJuniorSenior
Do you hold a valid U.S. Passport?*

YesNo

If "Other" is selected, please list the program provider, destination, host institution, and language of instruction.
Under the U.S. federal law (Section 438 of Public Law 90-247, as amended), students are permitted access to certain education records. Section 438(a)(2)(B) provides that a student may waive the right to inspect confidential letters of recommendation. Many applicants have found that a recommendation letter written in confidence has a greater impact than one to which the applicant also has access.*

I waive the right to inspect the information requested by this recommendationI do not waive the right to inspect the information requested by this recommendation
One recommendation from your advisor is required.

Upon submitting the application your advisor will automatrically be emailed with a request for a recommendation. We highly suggest you let your advusor know ahead of time.

Additional recommendations can be from a full-time faculty member or a full-time staff member. No relatives may recommend. Please provide additonal recommednations with this link: www.desales.edu/study-abroad/recommend
Advisor Name*
Title
Advisor E-mail

5. Personal Statement
Why do you wish to study abroad? Please upload your personal statement. (Max 100kb)
Attachment

Select File

Cancelof

6. Student Responsibilities and Acknowledgements
Yes, I am aware of and understand the expected behavioral responsibilities while participating in this optional program. As a guest in a foreign country, there are certain behaviors that are considered unacceptable and could lead to possible disruption of the program. I hereby assure the University that I shall conduct myself in an appropriate manner that does not infringe upon the laws, customs, and morals of the country in which the program is being conducted, nor upon the rights and safety of other participants of the program. Behavioral responsibilities shall be applicable during the course of the program both when in the company of other program participants and when I am physically separated from other program participants. In addition, I must adhere to all policies outlined in the DeSales University Student Handbook, and all rules and policies established for the program in which I am participating. DeSales University reserves the right to dismiss from school students studying abroad who disregard the laws or ordinances of host countries and local municipalities or who act in ways that contradict the Christian humanist mission of the University. If involved in alleged civil or criminal misconduct abroad, I am responsible for all costs, expenses, fees, and fines associated with any civil or criminal actions or penalties and for retaining my own counsel at my own expense.
Yes, I certify that the information submitted on this application is correct. I agree to be subject to the academic policies of DeSales University including those stated in materials describing the program and all pre-departure and orientation materials.
Yes, I authorize the director of international learning to have access to my educational and disciplinary records and I authorized the director to share such records with the program’s admission committee members.
Yes, I understand that submitting an application by the suggested deadline does not guarantee my acceptance into any program.
Yes, I agree to complete and return any additional forms related to my participation in a study abroad program to the Office of International Learning by the stated deadlines.
Yes, I understand that DeSales University reserves the right to change, cancel, or alter any provision of its programs as it deems necessary.
Signature: (By typing your name below, You agree that this is valid as your signature.)*
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