Name:
Address:
Phone number:
E-mail:

Emergency Contact Information:

Passport number:

Briefly list your previous travel experience:

Statement of purpose - why do you want to study abroad? Goals and expectations

Are you a minor?
What is your GPA?
What is your major?
What are some of your hobbies and interests?
What is your general level of health?
Do you have or have you had any mental or physical illnesses we should be aware of ?
Are you taking any medication?
Do you have any allergies?
Do you have a special diet?
Do you have any special needs?
Any additional information the program should be aware of?

Additional requirements:
Please provide a letter of recommendation from a professor by March 1st.
You also need an International Student ID card from a travel agent, which includes emergency health insurance and costs $25.

Basic policy for students

Passport: You will need a passport. If you don't have one yet, apply right away because it can take several months. Keep it in a safe place. Make several photocopies of the first page in case of loss.

School: Students are expected to attend classes every day, do assigned homework, and take school seriously. You are encouraged to take part in school activities and to get acquainted with other students. You are required to be enrolled at Austin Community College.

Living in a different culture: Different cultures have different ideas about appropriate behavior and dress. Be sensitive and considerate of cross-cultural differences. Living arrangements can not be changed without the permission of the program coordinator.

Travel: If traveling out of Lima outside of organized trips, you must inform the Program Coordinator of your itinerary.

I have read this policy. I agree to abide by it. I understand my failure to do so will result in my being sent home.

Student signature:
Date:

Please print out form, fill it out, and mail it with your deposit to:
Carol Hayman
SBS/ANT
Austin Community College
1212 Rio Grande
Austin, TX 78701

Make your deposit check for $100 payable to Austin Community College.