here the application form

SANT’ANNA STUDY ABROAD APPLICATION FORM
APPLICATION CHECKLIST
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Application Form
Copy of your unexpired, signed passport
Transcript with cumulative GPA of 2.5
Letter of program approval from academic advisor (if required)
One page personal statement describing personal and academic reasons for studying at Sant’Anna Institute
Student visas are required for semester programs. Sant’Anna Institute will assist in this process after the student is accepted.
Please send all application materials to Serena Vacca: serena.vacca@santannainstitute.com
Sant’Anna Institute-Sorrento Lingue
Via Marina Grande, 16, 80067 Sorrento, Napoli
Tel: +39 081 878 44 70 / +39 081 878 44 70 Fax: +39 081.532.41.40
PERSONAL INFORMATION
Last Name___________________________________
First Name________________________
 Female
 Male
Current University/College_______________________
Occupation_________________________
Country of Citizenship__________________________
First Language______________________
Date of Birth (mm/dd/yy) ________________________
Passport Number____________________
City/State of Birth ______________________________
Country of Birth______________________
Permanent Address____________________________________________________________________
City ________________________________________
Country_____________________________
Postal Code__________________________________
Email_______________________________
Phone/Fax___________________________________
Mobile phone_________________________
EMERGENCY CONTACT
Name______________________________________
Phone / Mobile_______________________________
How did you find out about SASL?
Relationship_________________________
E-mail_____________________________
Family/friend Istituto Italiano di Cultura Student Teacher
Google Ad
Internet search Website_____________
Educational Agency – Specify__________ Other __________
PRIVACY POLICY
SASL is registered to hold your personal data under the Italian data protection law. This information will be used for administrative
purposes
and will not be given to any third party. I authorize the use of my personal information bySant’Anna Institute , in accordance with
Italian Law D.
Lgs. 196/03 on privacy.
_____________________________________________________________________
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Sant’Anna Institue - Sorrento Lingue s.r.l
Via Marina Grande, 16 – 80067 Sorrento (Na) – Italy - Tel +39.081.807.5599 – Fax +39.081.532.4140
www.santannainstitute.com – info@sorrentolingue.com
P.Iva 07631160012
TUITION 2015 & PROGRAM SELECTION
FALL 2015 PROGRAM
August 30 – December 19, 2015
Courses noted as (ASC) are taught by Alfred State College faculty
All other courses taught by Sant’Anna Institute faculty.
All courses are 3 credit hours (45 contact hours) except as noted
All courses receive credit through Alfred State College (SUNY)
If you are interested in an interested in an internship for academic credit, please request this separate form.
ITALIAN LANGUAGE
ARTS & HUMANITIES
Italian 101: Elementary
Archaeology: Cities of Fire
Italian 102: Pre-Intermediate
Creative Writing: Travel and Experience
Italian 103: Intermediate
History of Italian Cinema
Italian 104: Upper-Intermediate
Italian 105: Advanced
Art History:
Ancient Greece and Rome to Italian Baroque
Italian 106: Post-Advanced
Introduction to digital photography
Italian 300 level
Drawing on Location, the Art of the Travel
BUSINESS ADMINISTRATION
Sketchbook
Business in the European Union
International Tourism (4 credits)
Territory and Entrepreneurship:
Tradition, Sustainability, Competition
SOCIAL SCIENCES
History of Western Civilization since 1648
Contemporary Italy:
Politics, Economy and Trade
NATURAL SCIENCES
Marine Biology
History of the Mafia
Anthropology of Europe
Geology
Mediterranean Culture and History
Volcanology
Sant’Anna Institue - Sorrento Lingue s.r.l
Via Marina Grande, 16 – 80067 Sorrento (Na) – Italy - Tel +39.081.807.5599 – Fax +39.081.532.4140
www.santannainstitute.com – info@sorrentolingue.com
P.Iva 07631160012
ITALIAN LANGUAGE PROFICIENCY
Select the appropriate level:

Beginner
Lower Intermediate
Intermediate
Upper Intermediate
Advanced
List the course title and level of your most recent Italian language course. ______________________________________________
How many semesters of Italian language have you completed? ______________________________________________________
SANT’ANNA INSTITUTE ABSENCE POLICY:
You are allowed two unexcused absences. Documentation for any other absence MUST be produced and
APPROVED the professor or the Director. For absences due to illness, please provide the professor with a
doctor's note upon returning to class as well as inform them and/or the school the first day of illness. Each
unexcused absence after the second will reduce your grade by 3 percentage points.
REGISTRATION POLICIES
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In the event of insufficient enrollment in particular courses (especially at the higher levels), SASL reserves the right to adjust
the balance of teaching/open studio hours.
Mid-term and final exams will be given only on the scheduled days that appear on each course syllabus. For no reason (i.e.
religious issues, travel plans, family matters, etc.) will they be moved. Exams are scheduled during normal class times, so
more than one exam may be administered on the same day.
Withdrawal from Courses: Not all courses have the possibility to be dropped. Students have two weeks to be able to add or
drop courses at the discretion of the Academic Program Coordinator.
PAYMENT
If a student visa is required, Sant’Anna is obligated to receive the full balance of tuition before releasing an official “Letter of
Acceptance,” which is one of the required documents for the student visa application.
If a student visa is not required, a deposit of 30% of the total tuition is due with the application; the remaining balance of the
tuition is due 30 days prior to the start of the term.
STUDENT VISA AND PERMIT OF STAY EXPENSES
Students are responsible for acquiring their student visas at their local consulate. Please refer to the consulate’s website for exact
information on required documents as it varies from region to region. Sant’Anna is available for assistance in this process. This
process is extremely sensitive and all instructions must be followed exactly according to the Consulat e’s regulations. Sant’Anna
strongly recommends that students contact the consulate directly to confirm that they have all the required documents before their
appointment.
Upon arrival in Sorrento, Sant’Anna will instruct students on how to apply for a ‘permesso di soggiorno’ (permit of stay). The
estimated costs of this application is 170 Euros which are strictly the costs imposed by the Italian government.
CANCELLATION POLICY
If an official cancellation notice is received by Sant’Anna:
- 20 days or more before the start of the term, the student will be liable for 10% of the full program fee.
- 19 to 7 days before the start of the term, the student will be liable for 20% of the full program fee.
- 6 days to the beginning of the term, no refund will be given.
After classes start, no refund will be due to students who do not attend or who withdraw from SASL.
Fees are not transferable to other persons.
Students will receive the refund minus the cost of any transfer fees.
I HAVE READ, UNDERSTOOD, AND WILL ABIDE BY THE ABOVE SASL POLICIES AND REGULATIONS.
Sant’Anna Institue - Sorrento Lingue s.r.l
Via Marina Grande, 16 – 80067 Sorrento (Na) – Italy - Tel +39.081.807.5599 – Fax +39.081.532.4140
www.santannainstitute.com – info@sorrentolingue.com
P.Iva 07631160012
MY SIGNATURE BELOW ALSO ATTESTS TO THE FACT THAT I HAVE BEEN MADE AWARE OF THE INFORMATION
REGARDING:
Student signature
________________________________________________ Date
_________________________
RETURN COMPLETED FORM BY EMAIL TO serena.vacca@santannainstitute.com
Fall 2015
Month
Date
Day
Event
June 2015
June 2015
June 2015
12
12-17
28
Friday
Fri-Tue
Sunday
Application Deadline
Confirmation Deposit
Final Payment Deadline
August 2015
30
Sunday
Arrival and Housing
31
Monday
Orientation & Courses Begin
October 2015
17-25
Sat-Sun
Fall Break
December 2015
18
Friday
Courses End
19
Saturday
Departure and Housing Check-out
Sant’Anna HOUSING REQUEST INSTRUCTIONS
The following are required for Sant’Anna to begin to process the initial housing request:
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Housing Request Form – completed and signed
For students enrolled in a semester program, the following are required by 30 days before the student arrival date:
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Two Copies of your visa (on your passport)
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Detailed travel Itinerary
PRIVACY POLICY
Sant’Anna is registered to hold your personal data under the Italian data protection law. This information will be used f or administrative purposes and will
not be given to any third party.
I authorize the use of my personal information by by Sant’Anna Institute, in accordance with Italian Law D.Lgs. 196/03 on privacy.
Student signature
________________________________________________ Date _______________
RESERVATION PROCEDURE
1. The student must return all of the required documentation to the Housing Department (see first page of this form)
2. About a week before the beginning of the term, the Housing Office will provide the student with (via e-mail):
a. type and address of the apartment, specifying room-mates and apartment-mates
b. information regarding Housing Check-in
PERSONAL PROFILE
Circle the number which most closely describes you and/or your living habits:
I am extroverted
3
2
1
Sant’Anna Institue - Sorrento Lingue s.r.l
Via Marina Grande, 16 – 80067 Sorrento (Na) – Italy - Tel +39.081.807.5599 – Fax +39.081.532.4140
www.santannainstitute.com – info@sorrentolingue.com
P.Iva 07631160012
I read a great deal
I practice sports
I watch TV a great deal
I love classical music
I like walking
I have a lot of friends
I care about my appearance
3
3
3
3
3
3
3
2
2
2
2
2
2
2
1
1
1
1
1
1
1
I go to bed late
I like cooking
I am tidy
I smoke*
3
3
3
3
2
2
2
2
1
1
1
1
Tell us about your personality, living habits, & anything else that will help us house you with the right people & in the rig ht place!
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Roommate
Request(s):___________________________________________________________________________________________
Allergies (if any):
________________________________________________________________________________________________
Other health problems that need to be taken into consideration:
_______________________________________________________________________________________________________
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Do you have any special conditions or needs that you would like the housing coordinator to be aware of? (e.g. anxiety disorder,
depression, learning disability, eating disorder, physical limitation, religious belief, etc.)
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
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Do you have any particular needs/requests? Please write them here. The Housing Department will let you know if the request can
be met.
Requests regarding Housing must be made on this
form._________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
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_______________________________________________________________________________________________________
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SASL is not responsible for personality conflicts among students sharing the same apartment.
PAYMENT REGULATIONS
1. The housing rent balance is due no later than 30 days before the student arrival date.
2. Students are responsible for paying for damages to the accommodations caused by student negligence. SASL requests a copy
of the student’s credit card upon arrival as a security deposit against any damages.
Sant’Anna Institue - Sorrento Lingue s.r.l
Via Marina Grande, 16 – 80067 Sorrento (Na) – Italy - Tel +39.081.807.5599 – Fax +39.081.532.4140
www.santannainstitute.com – info@sorrentolingue.com
P.Iva 07631160012
I appoint the Sant’Anna Institute to forward, in my name and on my behalf,
my payment of the housing rent and expenses as established and chosen in this application form.
I understand that:
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the accommodation assignment will be communicated to me about a week before my arrival;
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I will enter my apartment ONLY at the Check-in date, and I must leave the assigned apartment no later than 12:30 pm on Check-out day;
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In case of damages to the apartment, excessive use of the utilities and/or the apartment left in an unclean, or otherwise unacceptable
condition, the cost will be withheld from the deposit;
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SASL reserves the right to expel from the assigned apartment any student whose behaviour does not conform with civilized standards of
behaviour;
I HAVE READ, UNDERSTOOD, AND WILL ABIDE BY ALL OF THE SASL,
RULES, AND REGULATIONS ON THIS FORM.
Student signature
________________________________________________ Date _________________________
Print Student Name_________________________________________
Sant’Anna Institue - Sorrento Lingue s.r.l
Via Marina Grande, 16 – 80067 Sorrento (Na) – Italy - Tel +39.081.807.5599 – Fax +39.081.532.4140
www.santannainstitute.com – info@sorrentolingue.com
P.Iva 07631160012