here the application form

SANT’ANNA INSTITUTE
STUDY ABROAD APPLICATION FORM
SUMMER 2016
DATES OF THE PROGRAM:
- Summer 1: May 29 - July 2, 2016
- Summer 2: July 3 - August 6, 2016
- Summer 3 (Summer 1+2): May 29 - August 6, 2016
APPLICATION CHECKLIST:
 Completed Application Form
 Copy of your unexpired, signed passport
 One page personal statement describing personal and academic reasons for studying at SASL
 Transcript with cumulative GPA of 2.5 (unofficial transcript acceptable)
* Please remember that students entering Italy passing through the Schengen Area (U.K., Ireland, German,
Spain..) will have to apply for a Declaration of Presence after their arrival in Italy. The fee of the Declaration
is 18,15 € per student. Sant’Anna Institute will assist you during the process. If you enter
Italy DIRECTLY from your own Country, WITHOUT passing through the Schengen Area you DO NOT have
to apply for the Declaration of Presence. Please, be sure your passport is clearly stamped by the airport. If it
is not clear or there is not a stamp at all, you MUST apply.
Please send all application materials to Serena Vacca at [email protected]
Istituto Sant’Anna-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
DEADLINE FOR OUR SUMMER 2016 PROGRAM: March 31st, 2016
PERSONAL INFORMATION
Last Name___________________________________
 Female Male
First Name________________________
Social Security Number__________________________
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:
____________________________________________________________________________________
(Street)
(Apartment/Unit number)
City ________________________________________
Country_____________________________
State_______________________________________
ZIP Code____________________________
Current Mailing Address (if different from above):
____________________________________________________________________________________
(Street)
(Apartment/Unit number)
Sant’Anna Institue - Sorrento Lingue s.r.l
Via Marina Grande, 16 – 80067 Sorrento (Na) – Italy - Tel +39.081.807.5599 – Fax +39.081532.4140
www.santannainstitute.com – [email protected]
P.Iva 07631160012
City ________________________________________
Country_____________________________
State_______________________________________
ZIP Code____________________________
***
Email_______________________________________
Phone/Fax___________________________________
Mobile phone_________________________
How did you learn about Study Abroad at Sant’Anna Institute-Sorrento Lingue (SASL) ?________________
______________________________________________________________________________________
ACADEMIC INFORMATION
Class (when you’ll be abroad):
Cumulative GPA__________________________________
Projected Graduation Date_____________________________
Major___________________________________________
Minor (if applicable)__________________________________
EMERGENCY CONTACT
Parent/Guardian Name_________________________________
Relationship_______________________________________
Home Phone_________________________________________
Cell Phone________________________________________
Email Address________________________________________________________________
Street________________________________________________
City_________________________
State_____________________
Apartment/Unit_____________________________________
ZIP Code___________________
Country_____________
Family/friend Istituto Italiano di Cultura Student Teacher
Google Ad
Internet search Website_____________ Educational Agency – Specify__________ Other __________
How did you find out about SASL?
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.
________________________________________________________________________
Sant’Anna Institue - Sorrento Lingue s.r.l
Via Marina Grande, 16 – 80067 Sorrento (Na) – Italy - Tel +39.081.807.5599 – Fax +39.081532.4140
www.santannainstitute.com – [email protected]
P.Iva 07631160012
SUMMER 2016 PROGRAM
All course credit is transferable through Alfred State College (SUNY)
Please blacken the program you are interested in:
SUMMER I (May 29- July 2)
SUMMER II (July 3-August 6)
SUMMER I + SUMMER II (May 29- August 6)
If you are interested in an internship for academic credit, please see the form on page 9.
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
Survey of Italian Art History:
Ancient Greece and Rome to Italian Baroque
Italian 106: Post-Advanced
Drawing on Location, the Art of the Travel
Italian Medieval 1 Literature
Italian Medieval 2 Literature
Italian Modern Literature
Sketchbook
Introduction to digital photography
SOCIAL SCIENCES
Italian Contemporary literature
History of Western Civilization since 1648
NATURAL SCIENCES
Marine Biology
Geology
Volcanology
History of Contemporary Italy
History of the Mafia
Mediterranean Culture and History
BUSINESS ADMINISTRATION
Business in the European Union
Internship
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.
Sant’Anna Institue - Sorrento Lingue s.r.l
Via Marina Grande, 16 – 80067 Sorrento (Na) – Italy - Tel +39.081.807.5599 – Fax +39.081532.4140
www.santannainstitute.com – [email protected]
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? ______________________________________________________
REGISTRATION POLICIES



In the event of insufficient enrollment in particular courses (especially at the higher levels), S ant’Anna 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 m ore
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.
CANCELLATION POLICY
•

30% of the total fee to be paid upon enrollment
Remaining fee to be paid by 45 days from the beginning of the program
IF AN OFFICIAL CANCELLATION NOTICE IS RECEIVED BY SANT’ANNA:

Up to 60 days prior to the beginning of the term, the student will receive the refund of the deposit paid minus bank fees.

60-45 days prior to the beginning of the term, the student will receive the refund of the deposit paid
minus: bank fees and $300 of the housing reservation.

44-11 days prior to the beginning of the term, the student will be liable for half of the program cost plus bank fees

10-0 days prior to the beginning of the term, the student will be liable for the full program cost.

After the start of the program, liability amounts to the full program cost and no refund will be made.
I HAVE READ, UNDERSTOOD, AND WILL ABIDE BY THE ABOVE SASL POLICIES AND REGULATIONS.
MY SIGNATURE BELOW ALSO ATTESTS TO THE FACT THAT I HAVE BEEN MADE AWARE OF THE INFORMATION
REGARDING:
Student signature
___________________________________________ Date ______________________
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.
Student signature
_________________________________________________________ Date ____________________
RESERVATION PROCEDURE
1. The student must return all of the required documentation (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
Sant’Anna Institue - Sorrento Lingue s.r.l
Via Marina Grande, 16 – 80067 Sorrento (Na) – Italy - Tel +39.081.807.5599 – Fax +39.081532.4140
www.santannainstitute.com – [email protected]
P.Iva 07631160012
PLEASE ATTACH:



Copy of your unexpired, signed passport
One page personal statement describing personal and academic reasons for studying at SASL
Transcript with cumulative GPA of 2.5 (unofficial transcript acceptable)
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:

the accommodation assignment will be communicated to me about a week before my arrival;

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;

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;

Sant’Anna reserves the right to expel from the assigned apartment any student whose behavior does not conform with civilized standards of
behavior;
I HAVE READ, UNDERSTOOD, AND WILL ABIDE BY ALL OF THE LORENZO DE’ MEDICI POLICIES,
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 +39.081532.4140
www.santannainstitute.com – [email protected]
P.Iva 07631160012