If no, apply for your passport soon. It commonly takes 4-6 weeks to receive a passport.<br><br> Passport # ___________________ Expiration Date ____________ MM/DD/YEAR PARENT/GUARDIAN CONTACT ( FATHER ) ______________________________________________________ First Name Last Name ¡ Same as permanent address ______________________________________________________ Street Apt/Room# ______________________________________________________ City State Zip Home (______)_______________ Work (______)_____________ Cell (______)_______________ Fax (______)_____________ E-mail_________________________________________________ Employer___________________ Position___________________ PARENT/GUARDIAN CONTACT ( MOTHER ) ______________________________________________________ First Name Last Name ¡ Same as permanent address ______________________________________________________ Street Apt/Room# ______________________________________________________ City State Zip Home (______)_______________ Work (______)_____________ Cell (______)_______________ Fax (______)_____________ E-mail_________________________________________________ Employer___________________ Position___________________ Application Deadline: November 13, 2009 Contact the faculty leader(s) and the Study Abroad office for deadline exceptions. Prerequisites: One 100-level and one 200-level religion course Note: The operation of this program is subject to administrative approval and is dependent upon meeting the minimum enrollment target. APPLICATION CHECKLIST: ¡ Application completed and signed by the applicant ¡ $50 non-refundable application fee payable to Gonzaga University (cash/check only) ¡ Essay written and signed by the applicant ¡ Two academic recommendations ¡ Academic Services Clearance form 3 submit online ¡ Student Life Clearance form 3 submit online GENERAL INFORMATION How did you learn about the Spirituality & the Arts program?<br><br> ¡ Study Abroad Fair ¡ Study Abroad Office ¡ Gonzaga University Website ¡ Study Abroad Website ¡ Advertisement ¡ Former Participant ¡ Professor/Class ¡ Other (Please specify):____________________________________________________ List any activities/organizations in which you are currently a participant/member:____________________________________________ ________________________________________________________________________________________________________________ List any honors received :____________________________________________________________________________________________ How would you rate your health? ¡ Excellent ¡ Good ¡ Fair ¡ Currently under doctor 9s care If academic adjustments or accommodations will be needed during your study abroad, please contact the Gonzaga University Disabi lity Support Services at (509) 313-4134 six weeks in advance. Have you ever been convicted of a criminal offense or have a case pending against you at this time?<br><br> ¡ Yes ¡ No If yes, please provide complete details on a separate page. Consent to be contacted: Gonzaga receives requests from students who wish to contact current or previous participants in a program. Do you give Gonzaga 9s Study Abroad office permission to provide your e -mail address to other students?<br><br> ¡ Yes ¡ No APPLICATION INFORMATION T RANSCRIPT : The Study Abroad office will obtain your unofficial Gonzaga University transcript. A CADEMIC S ERVICES C LEARANCE F ORM : Complete this form online at the Study Abroad website. S TUDENT L IFE C LEARANCE F ORM : Complete this form online at the Study Abroad website.<br><br> A CADEMIC RECOMMENDATION FORM : Two academic recommendations are required. Academic recommendations should be from faculty who have instructed you in a three credit course. The recommendations are to be returned to you or the Study Abroad office in a sig ned, sealed envelope.<br><br> List the names of your academic recommenders: Name:___________________________ Position:___________________ Tel: (_____)__________ E-mail:__________________________ Name:___________________________ Position:___________________ Tel: (_____)__________ E-mail:__________________________ SHORT ANSWER QUESTIONS: Do you have any international or cross-cultural experience? If so, please describe. ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ Please describe your most intense group living or traveling experience?<br><br> ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ What are the three most important skills or attributes you would contribute as part of the England group? ________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________ P ERSONAL E SSAY : Please include an essay (500-750 words, typewritten and double-spaced) in response to the following question: What are the personal and academic goals you would like to accomplish on this study experience? This application will be reviewed by Drs.<br><br> Shalon Parker and Pat McCormick, Spirituality & the Arts of England Program Advisors, for final approval. A GREEMENT : I will enroll in the two 3-credit courses and will participate in the orientation programs. I will comply with the attendance policy, and maintain a good academic standing.<br><br> I agree to show consideration for fellow participants, faculty, administrators, and host country persons. I will abide by Gonzaga University 9s Code of Conduct, the laws of England, and all countries while traveling abroad. I will refrain from the abuse of alcohol, the use of illegal drugs, and behavior considered offensive in other countries .<br><br> I understand misconduct, excessive absences, or insufficient academic performance can result in dismissal from the progr am without financial consideration. The authority to take this action rests upon the faculty and staff. My signature indicates that the above information is factual and true, and that I will comply with the above agreement.<br><br> Signature: _______________________________________________________ Date: ________________________________________ SPIRITUALITY & THE ARTS APPLICATION 3 SIDE 2 TO THE STUDENT: Please complete and sign this section before giving the recommendation to a professor who has taught you in a three credit course. Your professor may return this form to you or Study Abroad in a signed, sealed envelope. Name ______________________________________________ GU ID# ______________ Class Status ¡ Fr ¡ So ¡ Jr ¡ Sr First Middle Last Name of program applying to___________________________ Term applying to ¡ Academic Year 2010-2011 ¡ Fall 2010 ¡ Summer 2010 ¡ Spring 2011 Phone (____)__________ E-mail________________________________________ Under the provision of the Family Educational Rights and Privacy Act of 1974, I waive my right of access to this recommendation and understand that the information provided will be used only for the purposes for which it was prepared (check one): ¡ Yes ¡ No Signature:________________________________________________________ Date:________________________________________ TO THE RECOMMENDER: You have been designated by this applicant to provide a recommendation.<br><br> Your confidential report of this student 9s academic background, intellectual ability, and maturity will help us in the selection process. Studying abroad requ ires constant personal adjustment. Your careful assessment of the student 9s qualifications will be appreciated.<br><br> STUDY ABROAD ACADEMIC RECOMMENDATION When and what course(s) did you teach this student? Are there any special considerations of which we should be aware? The following categories are intended merely as guidelines.<br><br> Please check the boxes or use the space provided for comments. We a re interested in a complete evaluation of whatever you deem important in describing this student. Please return this form to the student or to Study Abroad in a signed, sealed envelope.<br><br> The student 9s application will not be reviewed until this recommendation is received. Would you invite this student on a program if you were the director? ¡ Yes ¡ No If no, why?<br><br> In light of above, please check one: ¡ I recommend this applicant without reservation. ¡ I have minor reservations about this applicant 9s participation. ¡ I do not know the applicant well enough to recommend.<br><br> ¡ I cannot recommend this applicant. Name:________________________________________________ Position:________________________________________ Institution:____________________________________________ Department:_____________________________________ Address:______________________________________________ Tel: (________)__________________________________ _____________________________________________________ E-mail:__________________________________________ City State Zip Signature:_____________________________________________ Date:___________________________________________ Do not know Below Average Average Above Average Outstanding Academic ability Academic motivation Makes good decisions Class attendance Maturity Respect for faculty Respect for students Return to Gonzaga University Study Abroad , 323 E. Boone Ave.<br><br> or mail to Ad Box 85 " (800) 440 - 5391 " (509) 313 - 3549 " (509) 313 - 5987 fax " www.GoAbroadZAGS.org " studyabroad@gonzaga.edu TO THE STUDENT: Please complete and sign this section before giving the recommendation to a professor who has taught you in a three credit course. Your professor may return this form to you or Study Abroad in a signed, sealed envelope. Name ______________________________________________ GU ID# ______________ Class Status ¡ Fr ¡ So ¡ Jr ¡ Sr First Middle Last Name of program applying to___________________________ Term applying to ¡ Academic Year 2010-2011 ¡ Fall 2010 ¡ Summer 2010 ¡ Spring 2011 Phone (____)__________ E-mail________________________________________ Under the provision of the Family Educational Rights and Privacy Act of 1974, I waive my right of access to this recommendation and understand that the information provided will be used only for the purposes for which it was prepared (check one): ¡ Yes ¡ No Signature:________________________________________________________ Date:________________________________________ TO THE RECOMMENDER: You have been designated by this applicant to provide a recommendation.<br><br> Your confidential report of this student 9s academic background, intellectual ability, and maturity will help us in the selection process. Studying abroad requ ires constant personal adjustment. Your careful assessment of the student 9s qualifications will be appreciated.<br><br> STUDY ABROAD ACADEMIC RECOMMENDATION When and what course(s) did you teach this student? Are there any special considerations of which we should be aware? The following categories are intended merely as guidelines.<br><br> Please check the boxes or use the space provided for comments. We a re interested in a complete evaluation of whatever you deem important in describing this student. Please return this form to the student or to Study Abroad in a signed, sealed envelope.<br><br> The student 9s application will not be reviewed until this recommendation is received. Would you invite this student on a program if you were the director? ¡ Yes ¡ No If no, why?<br><br> In light of above, please check one: ¡ I recommend this applicant without reservation. ¡ I have minor reservations about this applicant 9s participation. ¡ I do not know the applicant well enough to recommend.<br><br> ¡ I cannot recommend this applicant. Name:________________________________________________ Position:________________________________________ Institution:____________________________________________ Department:_____________________________________ Address:______________________________________________ Tel: (________)__________________________________ _____________________________________________________ E-mail:__________________________________________ City State Zip Signature:_____________________________________________ Date:___________________________________________ Do not know Below Average Average Above Average Outstanding Academic ability Academic motivation Makes good decisions Class attendance Maturity Respect for faculty Respect for students Return to Gonzaga University Study Abroad , 323 E. Boone Ave.<br><br> or mail to Ad Box 85 " (800) 440 - 5391 " (509) 313 - 3549 " (509) 313 - 5987 fax " www.GoAbroadZAGS.org " studyabroad@gonzaga.edu

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