Universidad Autónoma de Querétaro

Universidad Autónoma de Querétaro
Program Application
Application Deadlines:
Fall 2009 & Academic Year 2009-10: March 2, 2009
Spring 2010: October 1, 2009
Instructions:
→Complete the following application only after receiving approval to study off-campus (see
Application Guidelines)
→Attach the following application materials:
- Official transcript (requested in the Registrar’s Office)
- One letter of recommendation from your most recent Spanish professor
- A list of courses you intend on enrolling in while studying at the UAQ (see website for a
complete listing, http://www.hope.edu/academic/language/spanish/queretarosemester.html)
- One page essay in Spanish, describing your reasons for studying in Mexico and the goals
you hope to accomplish during your stay at the UAQ.
→All materials must be submitted to the Fried International Center
This is an application for the following study period
□ Fall 2009
□ Spring 2010
□ Academic Year 2009-10
STUDENT INFORMATION
Name
First Name (Legal)
Date of Birth
Middle Name
Last Name
Country of Citizenship
Current Address
Campus Email
Campus Phone
Permanent Address
Current Academic Status
□ Freshman □ Sophomore □ Junior □ Senior
Academic Major(s)
Current Spanish Class(es)
Academic Advisor (name, department)
Letter of Recommendation (name, department)
Minor
Name
First Name (Legal)
Middle Name
Last Name
PARENT/GUARDIAN EMERGENCY CONTACT INFORMATION
Name
Name
Phone
Phone
Address
Address
HOUSING APPLICATION (USED ONLY FOR HOMESTAY PLACEMENTS)
Edad
Años
Alimentación
□ Variada
Sexo
□ Masculino
□ Feminino
□ Vegetariana
Entretenimientos (Hobbies)
Deportes Favoritos
¿Fuma?
□ Si
□ No
¿Padece algun tipo de alergía? □ Si □ No
Los Niños, ¿Le gustan?
¿Le molestan?
¿Aceptaría en la casa animales domésticos (perros, gatos, pájaros, etc)? □ Si □ No
¿Tiene algun problema de salud del que debamos saber, para ayudarle durante su
estancia en Querétaro? □ Si □ No
¿Cuál?
I certify that I am eligible to participate in this program and that the statements
made throughout this application are true and correct.
Signature
Date