HomeStudy AbroadOnline Application Study Abroad Online Application Study Abroad Application Personal Information First Name: * Last Name: * Student Email: * Personal Email: Phone: * Gender: * Male Female Citizenship: * AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe T-shirt size (men's sizing): XSSMLXLXXL I will be at least 18 years of age at the time of departure. * Yes No Do you have a valid passport? * Yes No, but I have applied for one. No, but I will have a passport six weeks prior to departure. If your passport expires within 6 months of the end of your program, you MUST renew your passport prior to departure. Reason for Interest Name of Desired Study Abroad/Exchange Program: * ArgentinaCosta RicaUganda, East AfricaUSAC Semester Program*USAC Summer Program*Other Name of Desired Study Abroad/Exchange Program: Specify Program Location: I meet the minimum GPA requirement for this program. * Yes No Exchange Type: * Fall Semester Spring Semester Summer Semester Full Year Year: * How did you learn about this study abroad program? Check all that apply: Word of Mouth Flyer on Campus Email OtherOther Please describe in a personal statement how the program suits your academic and personal goals. * Emergency Contact Information Contact's Name: * Contact's Phone: * Contact's Email: * Relationship: * MotherFatherGrandparentBrotherSisterAuntUncleLegal GuardianOther Relationship: Contact's Address * Contact's Address Contact's Address Contact's Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Academic Information Are you currently attending Utah Tech University? * Yes No Digital ID: Example: D00123456 Student Status: * FreshmanSophomoreJuniorSeniorGraduateOther Student Status: Major: * Semester/year you last attended UT: International Experience Have you ever lived, traveled, or studied in another country? * Yes No Please describe: Foreign Language Experience Please list the highest college-level courses you will have taken (if any) prior to the beginning of the program: Language(s): Course Number(s): How do you intend to pay for the trip? Check all that apply: Personal Funds Scholarships Fundraising Other May the Office of International Programs release your name to other participants? * Yes No I certify that all statements made on this application are entirely true and accurate. * I agree Signature Clear After clicking submit you will be directed to the payment portal in order to pay the non-refundable $35 Study Abroad Application Fee. Your application is not fully submitted until you receive confirmation of payment. If you are human, leave this field blank.
