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CIEE Study Center at University of Seville, Seville, Spain

Liberal Arts Program, Fall 2004

Instruction Sheet & Checklist


CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004
1. Print, complete and remit as directed the following information.

The following forms are due May 1, 2004 (with the exception of the Medical Form which is due June 1). Failure to
return required forms by the designated deadline may result in withdrawal from the program. Should you
foresee any delay in the remittance of any required form, please contact your CIEE Enrollment Officer
immediately.

‰ Participation Confirmation: To confirm your place on the program, return this form as soon as possible. Please see
the Participation Confirmation Form for details. If you are paying the deposit by credit card please fax this form.
Please do not fax and then mail if paying by credit card-you may be charged twice! If you are paying by check,
please mail, do not fax. If you do not intend on participating, please note that on the form and return to CIEE.

‰ CIEE Program Participant Contract: This form includes terms and conditions and release of CIEE from liability
information and MUST be signed by all participants.

‰ Medical Report Form: The deadline for this form is June 1st. This form must be completed and signed by a medical
doctor. Make your appointment NOW.

‰ CAIE Form: This form must be completed and sent to CIEE ONLY IF YOU WISH to pursue the Certificate of
Achievement in International Education.

‰ Course Pre-Registration Form: This form must be completed and you must have it signed by your academic advisor
before you return it to CIEE.

Please fax completed forms by May 1 (June 1 for the Medical Form) to:
207-253-0697
(Make sure to fax both sides of any double-sided form!)

If you cannot fax your forms, please mail them to:


CIEE – Spain Programs
7 Custom House Street, 3rd Floor
Portland, Maine 04101-4739

2. VISA REQUIREMENTS:

‰ You are required to obtain a student visa prior to departure. Please read the attached guidelines carefully as they will
give you advice on how to get your visa. It is imperative that you GET STARTED RIGHT AWAY.

3. PLEASE NOTE: In the coming weeks you will be receiving several e-mails from Cari Balbo (CBalbo@ciee.org),
your Enrollment Officer for Spain, regarding housing preferences/special needs, contact information, and your
flight arrival info. Please watch out for these emails at the email address you specified on your application.

- REMINDER -
Return to the Spain webpage to download and print the PROGRAM HANDBOOK and PROGRAM DATES,
DETAILS & UPDATES
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Participation Confirmation
CIEE Study Centers
Summer/Fall 2004

Name (please print) ______________________________________________________________________

Program ________________________________________________________________________________

Current/Sponsoring U.S. Institution ___________________________________________________________

Social Security Number ____________________________________________________________________

Term(s) – check all that apply: ο 2004 Fall ο 2005 Spring


ο 2004 Summer ο 2005 January Term ο Other ________

Submission of this Participation Confirmation reserves your place in the program and indicates that you (the above listed
participant) understand and agree to all CIEE payment, cancellation and refund policies as outlined in the CIEE Program
Participant Contract and on the website.

Confirmation Payment
$300 payment is required as part of the submission of this form. This confirmation payment is not an additional fee but is
part of the published program fee. Please indicate below how you will provide payment.
**Contact your current/sponsoring institution if you are not sure about payment procedures. Questions about payment policies or procedures should be
addressed to Kathy McCrea, CIEE Manager of Registration and Student Accounts at 207-553-7600.

‰ I applied through a School of Record - Please note: If you applied through a School of Record (Spelman College,
Wittenberg University, University of Connecticut, or University of Rochester) you should send your $300
confirmation payment to CIEE with this form. If you applied through Northern Illinois University all payments should
be made to Northern Illinois University. It is not necessary for the School of Record to sign this form.

‰ My $300 confirmation payment is enclosed

{ Enclosed is a check in the amount of $300 payable to CIEE

{ I would like to pay by credit card Type of card: { MasterCard { Visa

Print name of cardholder


Account number Expiration Date
Telephone number of cardholder
Authorized signature

‰ My sponsoring institution will pay the $300 confirmation payment at a later date.

This option requires that your study abroad advisor complete the section below:
Study Abroad Advisor:
Name and Title:
Telephone:
Signature: Date:
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

CIEE Program Participant Contract


This form is important. It includes terms and conditions and releases CIEE from liability. All
participants MUST sign this form.

Name (please print) _______

Program _______

Term(s) – (check all that apply) ο 2004 Spring ο 2004 Summer ο 2004 Fall ο Other ________

I understand and agree that this agreement shall constitute a binding agreement between the undersigned and "CIEE". "CIEE" is
defined to include: the Council on International Educational Exchange, its owners, agents, directors, officers, employees,
representatives, affiliates, sponsoring and/or cooperating educational institutions and contracted educational institutions involved with
the program known as CIEE Study Centers.

1. I certify that I do not have any physical or mental 4. I understand that I am solely responsible for any and
condition which will create a danger or hazard for me, all expenses and costs incurred by me before, during
other participants or hosts in the program. and after the program except for the costs of items,
which are expressly listed in the CIEE Study Center
2. I understand that I am solely responsible for my pre- catalog. Under no circumstances will CIEE be
program, program, and post-program medical care in all responsible for any of participant’s expenses incurred in
respects, including, but not limited to, obtaining and preparing for the program. Said expenses include, but
taking necessary medication(s), vaccinations and any are not limited to, advance purchase air tickets,
other medical care and treatment. I certify that I will equipment, visa fees, passport fees, medical expenses,
consult a physician qualified in travel medicine, or any other expense incurred by participant in
immunizations and infectious/tropical diseases prior to preparation for the program.
my trip departure.
5. I understand and agree that if CIEE causes to be
3. I understand that I am obligated to comply with local secured a visa for a participant and said participant
laws and customs while traveling abroad. Many such withdraws or is dismissed from the program before
local laws and customs may be substantially different departure or during program, the participant may not
from those in my home country. I recognize that my use the visa to enter or remain in the program country. I
conduct can have an effect on the educational and other understand that CIEE may report withdrawal to
benefits intended by the program for other participants, appropriate immigration officials of the program country.
hosts and myself. I agree to conduct myself in a manner
that will support mutually beneficial interaction with other 6. I understand and agree that if I withdraw from a
participants and hosts. I understand that conduct program, I must notify CIEE in writing about my
considered unacceptable to CIEE includes, but is not withdrawal. Withdrawals are effective only upon the date
limited to, excessive use of alcoholic beverages, loud of receipt of written notification by CIEE International
and/or abusive behavior toward others, sexual Study Programs department.
harassment, criminal conduct of any kind, use of drugs
other than prescribed drugs for legal medicinal For fall and spring term participants, the withdrawal
purposes, and/or unwillingness to cooperate with other refund policies are as follows:
members of the program, hosts and program
management. Such conduct as well as any other Withdrawal before the program starting date: If written
conduct which in the sole discretion of CIEE may be notification of withdrawal or deferral of participation is
damaging to the program, other participants, working received by CIEE more than 30 days prior to the
relations with governments, suppliers and educational program starting date, all fees minus the $30 application
institutions with whom CIEE contracts/cooperates, may fee and the $300 non-refundable confirmation payment
lead to dismissal of participant from the program. will be refunded. In the case of deferral, the non-
Dismissal of participant by CIEE will not reduce the refundable application fee may be applied towards
obligation of the undersigned for payment of full program future participation on this or another CIEE Study Center
costs. Program, within the next 12 months.
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

If written notification of withdrawal or deferral of deferral, the 25% of the program fee may be applied
participation is received by CIEE less than 30 days prior towards future participation on this or another CIEE
to the program starting date, 75% of the program fee Study Center Program within the next 12 months.
less the $300 non-refundable confirmation payment will Requests for program deferral to a different semester
be refunded. The $30 application fee is non-refundable. are only accepted up until the program start date.
(In the case where payment has not yet been received
by CIEE, 25% of the program fee is due.) Requests for In the case of deferral, the non-refundable confirmation
program deferral to a different semester are only payment and 25% of program fee (if request is received
accepted up until the program start date. less than 30 days from the start of the program) may be
applied towards future participation on this or another
In the case of deferral, the non-refundable confirmation CIEE Study Center program, within the next 12 months.
payment and 25% of program fee (if request is received All students who defer acceptance to a program after
less than 30 days from the start of the program) may be confirmation will be sent a CIEE Program Reactivation
applied towards future participation on this or another Credit Form. This form outlines the amount paid by the
CIEE Study Center program, within the next 12 months. student toward their initial program, and must be
All students who defer acceptance to a program after returned to CIEE upon reactivation of their program
confirmation will be sent a CIEE Program Reactivation application in order to receive a credit toward the fees
Credit Form. This form outlines the amount paid by the for the new term. In order to be valid, the CIEE Program
student toward their initial program, and must be Reactivation Credit Form must be returned by the
returned to CIEE upon reactivation of their program application deadline for the term of reactivation, and the
application in order to receive a credit toward the fees student’s previous account balance must be zero.
for the new term. In order to be valid, the CIEE Program
Reactivation Credit Form must be returned by the Withdrawal on or after the program starting date: If
application deadline for the term of reactivation, and the written notification of withdrawal is received by CIEE on
student’s previous account balance must be zero. or after the program starting date, the following refund
policy applies (Please note that the $30 application fee
Withdrawal on or after the program starting date: If and the $300 confirmation payment are non-refundable
written notification of withdrawal is received by CIEE on and refunds are calculated on the program fee less the
or after the program starting date, the following refund confirmation payment):
policy applies (Please note that the $30 application fee
and the $300 confirmation payment are non-refundable • Withdrawal on or up to 2 days after the
and refunds are calculated on the program fee less the program start date – 50% refund
confirmation payment): • Withdrawal at any time after Day 2 of the
program – no refund is given
• Withdrawal on or up to 14 days after the
program start – 50% refund 7. CIEE reserves the right to make changes in the
• Withdrawal between Day 14 and Day 28 from program’s itinerary sequence, as well as other changes,
the program start – 25% refund including, but not limited to, substitutions of or changes
• Withdrawal at any time after Day 28 of the in courses, excursions, activities, lectures, site visits and
program – no refund is given. topics listed currently in the catalog. Any and all such
changes are without liability on the part of CIEE.
For summer term, June Intensive Language Program,
and January Intensive Language Program participants, 8. All CIEE programs are based on group arrangements
the withdrawal refund policies are as follows: involving a minimum number of participants. In the
unlikely event that a program is cancelled (due to low
Withdrawal before the program starting date: If written enrollment or any other reason), CIEE will refund all
notification of withdrawal or deferral of participation is payments received but will have no further liability to
received by CIEE more than 30 days prior to the participant.
program starting date, all fees minus the $30 application
fee and the $300 non-refundable confirmation payment 9. All program participants are covered under CIEE
will be refunded. In the case of deferral, the non- Accident & Sickness Insurance. Coverage provided by
refundable application fee may be applied towards this policy is meant to supplement private insurance and
future participation on this or another CIEE Study Center to provide coverage for activities related to traveling
Program within the next 12 months. abroad. I understand that detailed information on the
coverage of this policy has been made available to me.
If written notification of withdrawal or deferral of Further medical, evacuation, trip cancellation, trip
participation is received by CIEE less than 30 days prior interruption, baggage loss/damage, accident/sickness
to the program starting date, 75% of the program fee and any and all other applicable insurance is strongly
less the $300 non-refundable confirmation payment will recommended. I understand that health care and
be refunded. The $30 application fee is non-refundable. evacuations outside my home country are not covered
(In cases where payment has not yet been received by by most standard insurance policies and can be
CIEE, 25% of the program fee is due.) In the case of extremely expensive. I am solely responsible for
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

payment of any and all medical evacuation, trip poisoning, lack of, access to or quality of medical care,
cancellation, trip interruption, baggage loss/damage, difficulty in evacuation in case of a medical or other
accident/sickness and any and all other insurance emergency, or for any other cause beyond the direct
expenses incurred by me during my program or related control of CIEE.
to my program. I understand I am solely responsible for
my medical, psychological and physical condition during 12. I understand that perceived or actual epidemics
the duration of my program with CIEE. Should any (such as, but not limited to, SARS) can delay, disrupt,
medical, psychological or physical problems arise during interrupt or cancel programs. I agree to assume all risk
the course of my program with CIEE, I am solely of any such problems which could result from any such
responsible for any and all care that I may need. I occurrences.
understand and agree that I am also solely responsible
for paying for the costs and expenses of any such care. 13. CIEE retains the right, in its sole discretion, to
contact participant’s school, parents and/or guardian
10. Unless I check the box below, I understand that with regard to health issues or any other matter
CIEE will distribute my name, address, email address whatsoever which relates to participant or participant’s
and telephone number to other program participants, program. These rights transcend any and all privacy
staff and sending schools. regulations that may apply.

… I do not wish to have my name, address, 14. I understand that travel in other nations is not
email address and telephone number shared similar to travel within the United States. Programs
with persons who are not official CIEE outside the United States can involve inconvenience
directors, officers, representatives, affiliates, and risk, including, but not limited to, forces of nature,
sponsoring and/or cooperating educational geographic and climatic conditions, different hygienic
institutions and contracted educational standards, infrastructure problems (including road
institutions involved in the CIEE Study Center maintenance, transportation delays and accommodation
program, but all information regarding my conditions or available at all), civil unrest, political
application and participation in the program stability and terrorism. Medical services or facilities may
may be released to “CIEE”. not be readily available during all or part of a program
and, if available, may not be equal to standards in
11. CIEE does not own or operate any entity which is to participant’s home country. I assume all risk of bodily
or does provide goods or services for your program injury, death, emotional trauma, property damage,
(except that it employs resident directors and staff), inconvenience and/or loss resulting from negligence or
including, for example, arrangements for or ownership or any other acts of any and all persons or entities,
control over houses, apartments or other lodging however caused, including, but not limited to, those risks
facilities, airline, vessel, bus or other transportation mentioned above. It is my intention fully to assume all of
companies, local ground operators, visa processing the risks of travel and participation in the CIEE program
services, providers or organizers of optional excursions, and to release CIEE from any and all liabilities to the
food service or entertainment providers, etc. All such maximum extent permitted by law. If this form is also
persons and entities are independent contractors. As a signed by a parent or legal guardian, that parent or
result, CIEE is not liable for any negligent or willful act or guardian is making a similar release.
failure to act of any such person or entity, or of any third
party. Without limitation, CIEE is not responsible for any 15. CIEE, in its sole discretion, can approve or
injury, loss, or damage to person or property, death, disapprove of any participant’s change of housing
delay or inconvenience in connection with the provision including, but not limited to, participant opting out of
of any goods or services occasioned by or resulting CIEE provided housing. If CIEE agrees to allow
from, but not limited to, acts of God, force majeure, acts participant to choose his or her own housing, participant
of war or civil unrest, insurrection or revolt, strikes or agrees that CIEE is not responsible for any problems
other labor activities, criminal or terrorist activities of any which result therefrom.
kind, overbooking or downgrading of accommodations,
structural or other defective conditions in houses, 16. CIEE reserves the right to decline, accept, dismiss,
apartments or other lodging facilities (or in any heating, or retain any person as a participant in any program at
plumbing, electrical or structural problem therein), any time before or during the program for any reason
mechanical or other failure of airplanes or other means whatsoever, without liability for refund of payment
of transportation or for any failure of any transportation except refunds regarding cancellation by CIEE of
mechanism to arrive or depart timely, dangers programs will be issued as per the terms of paragraph 6
associated with animals, sanitation problems, food above.
17. CIEE reserves the right to take photographic or 18. If by my acts or omissions I cause or threaten to
film records of any program. I understand that CIEE cause damage of any kind whatsoever to third parties,
may use such records for promotional and/or I accept full responsibility therefor. Further, in the
commercial purposes without limitation and without event of such damage or loss, I agree to indemnify
liability. and hold CIEE harmless from any and all actions
taken by third parties for said damages or loss.
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

against CIEE fail to prevail, I, or my legally designated


19. This "Release and Agreement Form" shall be representative, hereby agree to pay all reasonable
legally binding upon myself, all minors traveling with attorneys’ fees incurred by CIEE arising from the
me, my heirs, successors, assigns and legal dispute.
representatives. This entire agreement is entered into
on behalf of all members of my family who accompany 23. In the event any part of this "Release and
me. I certify that I am the parent or legal guardian of Agreement Form" is found to be legally void or
any legal minors under the age of majority who unenforceable, then such part will be stricken but the
accompany me. rest of this document will be given full force and effect.

20. All program applications are subject to 24. I have carefully read this document entitled
acceptance by CIEE in Portland, Maine, U.S.A. "Release and Agreement Form" and I have carefully
read all of the CIEE catalogues, program brochures
21. I agree that any dispute concerning, relating, or and other descriptive materials provided to me by
referring to this contract, the brochure, or any other CIEE relating to my participation in the program and I
literature concerning my program, or the program have understood all of the contents of all such
itself shall be resolved exclusively by binding documents. I understand and agree to comply with all
arbitration in Portland, Maine, according to the then stated terms and conditions set forth in this "Release
existing rules of the American Arbitration Association. and Agreement Form" as well as those terms and
Such proceedings will be governed by substantive conditions set forth in the CIEE catalogues, brochures
Maine law. and other descriptive materials provided to me by
CIEE relating to my participation in the program. I
22. Any claims on my behalf shall not exceed the understand that the terms and conditions in this
sum of the listed cost of my program with CIEE as document as well as the terms and conditions in all of
listed in the CIEE Study Center catalog. I further the above stated documents constitute a binding
agree that should any legal action on my behalf contract between myself and CIEE.

I certify that all statements made in this "Release and Agreement Form" are true and correct and made of my own
free will.

Signature of Participant Date

Signature of parent or legal guardian of participant if participant is Date


under the age of majority in the jurisdiction where this document is
signed.
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Medical Report Form


Name (please print)

Program

Term(s) (check all that apply): ο 2004 Spring ο 2004 January Term ο 2004 Spring/Fall ο 2004 Fall
ο 2004 Summer ο 2004-2005 Fall/Spring ο Other _____________

About Medical Insurance

CIEE provides all program participants coverage under the insurance policy: CIEE Accident & Sickness Insurance. Coverage provided by this policy is meant to
supplement your private insurance and to provide coverage for activities related to traveling abroad.

CIEE Accident & Sickness Insurance: Each participant is covered by an Accident & Sickness Insurance policy designed to cover the cost of accidents and routine
sicknesses while abroad. Additionally, the policy offers Emergency Evacuation coverage, together with a 24-hour Worldwide Assistance Service. Coverage
begins two weeks before the program’s start date and continues for two weeks after the day of the program. A complete description of the Accident & Sickness
Insurance policy, including a claim form, is included on the website at http://www.ciee.org/alumni.cfm?subnav=Alumni .

The CIEE Accident & Sickness insurance policy is designed as an additional or supplemental policy only, and does not cover liability. The policy does not include
coverage for routine physical or dental examinations or preventative medicine. Students are not covered for injuries resulting from acts of war or other political
unrest such as riots and demonstrations.

If you are covered by a personal or parental insurance plan, CIEE recommends that you continue this coverage while abroad. Prior to departure, you should
contact your current insurance carrier concerning coverage for accidents, illnesses, and liability cases that occur outside the United States. Check your policy's
limitations before making any assumptions about coverage.

Most U.S. based insurance companies will not cover property lost or stolen overseas. It is important that you read all policy information carefully and note exactly
what coverage is provided; note items that are excluded from coverage. CIEE strongly recommends that coverage, beyond that which is provided as part of the
program, is secured and understood by the participant before departure.

CIEE recommends that you name a beneficiary to this policy. Please use the space below to designate a person that will serve as a beneficiary for insurance
purchased on your behalf by CIEE International Study Programs.

Name of beneficiary Address Relationship to insured

To the Applicant
Please fill out the reference data below and then give the form to your physician. Participation in the program is contingent upon CIEE International Study
Programs staff receiving a completed medical report from you and your physician. Your doctor should complete this report based on an examination within four
months of the program departure date. Provide your physician with a stamped envelope addressed to CIEE, International Study Programs, 7 Custom House
Street, 3rd Floor, Portland, Maine, 04101-4739. Please be sure the physician knows the deadline for returning this form to the CIEE International Study Programs
home office.

Note: It is our policy not to accept reports filled out by a parent-physician.


CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Participant’s Name (please print)___________________________


To be completed by the applicant: Every item must be completed. If more space is needed than is available, please provide information on a separate page.
YES NO
1. Do you have any present medical problems, under the regular care of a physician or other medical health provider? Please explain.

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________
2. Are you under the regular care of a psychiatrist, psychoanalyst, psychologist or other mental health provider for any mental, emotional,
or nervous disorder? Permission may be requested for a confidential report of additional information from the psychiatrist or therapist.
3. Does your health prevent you from participating in any physical activities? Please explain.

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________
4. Are you taking any prescription medications regularly? If yes, please list the medication(s) along with the condition(s) for which they
were prescribed.

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________
5. Have you been hospitalized in the past five years? Please explain.

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________
6. Do you have any allergies or reactions to any medications, foods, insects or other agents? If yes, please list which ones and describe
the effects?

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________
7. Have you ever had any of the following? If you check yes to any box, please explain in detail on a separate page.

ο Heart Disease ο Vision/Hearing Impairment ο Eating Disorders


ο High Blood Pressure ο Diabetes ο Sleep Disorders
ο Asthma/Lung Disease ο Hepatitis or Jaundice ο Epilepsy/Seizure Disorders
ο Stomach/Intestinal Problems ο Arthritis ο Mental Illness
ο Foot, Leg or Back Problems ο Altitude Sickness

8. Do you currently have any of the following symptoms: Chest pain/pressure with exertion, heart palpitations, unexpected sweating,
shortness of breath, dizziness/fainting, muscle cramps? Please explain.

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________
9. Do you require any special support because of a learning disability? If yes, please attach a letter specifying the special support received
at your home institution.
10. Are you currently on a restricted diet? Please explain, and mention vegetarianism if applicable.

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________
I hereby certify to CIEE that I am solely responsible for my medical, psychological and physical condition for the duration of my program with CIEE. I am aware of
any medical, psychological and physical problems that would, in any way, impair my ability to participate in this program. Should any medical, psychological or
physical problems arise during the course of my program with CIEE, I am solely responsible for obtaining any and all medical, psychological and physical care
that I may need. I am solely responsible for paying for the costs and expenses of any such care. I am solely responsible for having adequate insurance
coverage for any such care, including, but not limited to, adequate insurance coverage for the costs and expenses of trip cancellation, evacuation, baggage loss
or damage, trip interruption, travel accident/sickness, and medical care.

Signature of Participant Date

Signature of parent or legal guardian of participant if participant is under the age of majority in Date
the jurisdiction where this document is executed.
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Participant’s Name (please print)___________________________


To the Physician
You are being asked to provide information on the physical and mental health of the above-named student for participation in the program listed above.
Depending upon the program, participants spend anywhere from 3 weeks to 12 months studying abroad. The pressures of living and studying abroad are
considerable. It is extremely important that all participants be able to adjust to dramatic changes in climate, diet, and living conditions. Living overseas can also
create emotional and physical stress for those not able to meet the demands of living in a new and different environment. In some cases, mild disorders can
become serious under the stress of life in alien surroundings. Students generally live in university dormitories or in homes with local families; in some cases,
participants live and study in situations that offer few amenities and little privacy. They need tact and sensitivity when dealing with people of their host country and
with the members of their own group.

It is essential that your reply be based on a current and thorough physical examination and knowledge of the applicant’s medical history. Any additional
comments relevant to the patient’s physical or psychological condition should be provided on a separate sheet signed and dated by you, the physician. Return
your evaluation in the envelope provided by the applicant.
To be completed by the physician:
1. How long have you known the 2. What is the date of the applicant’s
applicant? most current examination?

3. Are you: 4. What is the applicant’s general state of health?


ο Applicant’s family physician
ο College physician ο Excellent ο Good
ο Other ο Fair ο Poor

5. Please indicate the applicant’s vital signs (at rest): a. Pulse Rate b. Skin

c. Respiration d. Temperature e. Blood Pressure

If the answer to any of the following questions is yes, please give details on a separate sheet. In each case please indicate whether the condition is likely to affect the
student’s full participation in the program.
YES NO
6. Are the statements given by the applicant on the “To the Applicant” portion of this form accurate to your knowledge? If not, please
explain.
7. Is the applicant seriously underweight or overweight?
8. Is the applicant currently taking any medications?
9. Is the applicant allergic to any form of medication?
10. Has the applicant received the following immunizations? If yes, please provide the date of last immunization.
DATE
a. Diphtheria, Pertussis, Tetanus (DPT)
b. Mumps, Measles, Rubella (MMR)
c. Polio (Oral or Injectable)
d. Hepatitis A
e. Hepatitis B
f. Typhoid
g. Other ____________________________________________
11. Has the applicant ever suffered from asthma or any other respiratory ailment?
12. Is the applicant currently under treatment or observation for any physical or emotional condition?
13. Does the applicant have any speech, hearing, or eyesight impairment that might affect participation in the program?
14. Has the applicant any physical disability that might cause hardship through change of diet, carrying luggage, or strenuous travel?
15. In your judgment will the applicant require assistance from an aide or other second party because of an existing condition at any
time on the program?
16. Is there any congenital malformation now existing that may require additional treatment? If yes, what is this congenital condition
and what treatment is to be pursued? (Please note that CIEE’s insurance coverage does not include treatment of preexisting
conditions.)
17. Does this person have a history of emotional disturbance? Has the applicant displayed any of the following? Please explain.
a. difficulties in relations with parents, authority figures, peers
b. behavior disorders
c. symptoms such as mood swings, depression, severe sleep disorders, unusual degree of anxiety, fear, or guilt
18. To your knowledge, are there any predisposing medical, surgical, or emotional factors that may under stress or duress during the
program present a need for immediate therapy while abroad? Please explain.
Any additional comments relevant to the patient’s physical or psychological condition should be provided on a separate sheet signed and dated by you, the
physician.

Physician’s Name Physician’s Signature Date

Physician’s Address Physician’s Phone Number


CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

CIEE Certificate of Achievement in International Education


Fall 2004

Name (please print) _______

Program _______

Term(s) – (check all that apply) ο 2004 Summer ο 2004 Fall ο 2005 Spring ο Other ________

Objective:
The Certificate in Achievement in International Education (CAIE) is offered to students who wish to who
wish to show a specific international education credential on their résumé. The CAIE is a way for CIEE to
acknowledge students who want to immerse themselves fully in the experience of international education
and are willing to put forth extra effort, time, and study into this rewarding endeavor. The objective is to
provide students with tools to help them gain understanding of the host country culture and reflect on
American culture, acquire knowledge, and develop skills for living in a globally interdependent and
culturally diverse world.

Methodology:
The granting of the Certificate of Achievement in International Education is based on the student’s
performance and achievement, and includes criteria related to attendance, participation and a final paper.
This is accomplished through an extensive reading list, group and one-on-one meetings with the Resident
Director, experiential exercises, and the completion of a paper.

Logistics:
The certificate is offered outside the regular CIEE Study Center course requirements and works like an
independent study course. Successful students are highly motivated, independent learners. The
certificate option is offered outside of the regular CIEE Study Center course requirements and carries an
additional, non-refundable fee of $300 USD. In order to plan accordingly for those who elect to pursue the
Certificate, participants must decide whether or not they would like to pursue this certificate prior to
departure.

Instructions:
Please return this form if you wish to pursue the CAIE. Please indicate below how you will pay the
additional $300 fee.

1 YES! I wish to pursue the Certificate of Achievement in International Education.

{ Enclosed is a check in the amount of $300 payable to CIEE.

{ I would like to pay by credit card. Type of card: { MasterCard { Visa

Print name of cardholder


Account number Expiration Date
Authorized signature
Telephone number of cardholder
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Course Pre-Registration Form


CIEE Study Center at the Universidad de Sevilla, Seville, Spain
Liberal Arts Program, Fall 2004

Name: _________________________________Sponsoring Institution: _______________________________

Email: _____________________________________ (a working email where we can reach you prior to departure)

****RETURN TO CIEE BY May 1, 2004****


If you return this form early, it is more likely that you will be registered for your first choice courses. If this
form arrives after the deadline, you may not be able to enroll in the courses you have selected.

• Complete this form in consultation with your academic advisor who MUST SIGN this form. CIEE
CANNOT process registration forms without the appropriate number of courses selected and an
advisor’s signature.

• Changes to your course pre-registration in Seville will be permitted ONLY under the following
circumstances: time conflict with courses selected; space availability, and the results of on –site
language evaluation. CIEE Staff strongly recommends that students take at least one language
course during the semester to reinforce overall Spanish language acquisition.

• All permitted changes on-site MUST be approved by your academic advisor IN WRITING.

Refer to the 2004-2005 Program Catalog and the online Program Handbook (http://enrollment.ciee.org) for
course descriptions and academic policies. Course descriptions are also listed on our website. Copies of
syllabi are available upon request.
Recommended credit for each course is 3 semester/4.5 quarter hours.

I. Required Intensive Language Program Course: These courses will complete the 45 contact hours: 3
semester/4.5 quarter credit class.

Place an “X” before 1 first choice course from the list below. Please note: students who place below a certain
percentile in their language placement exam, will be required to take SPAN 3501 CSCS: Spanish Life through
Advanced Spanish Grammar during the intensive session.

______ SPAN 3501 CSCS: Spanish Life through Advanced Spanish Grammar
This intensive language class emphasizes all areas of linguistic competence in order to strengthen
the student’s ability to perform well in content classes taught exclusively in Spanish. Special focus
is placed on social and cultural issues related to Seville in the Andalusian and Spanish context.
This class has several levels in which students are placed based upon the results of the language
exam. Class size is limited to 15 students
______ HISP 3502 CSCS: Cultural History of Spain - (Recommended for students with advanced Spanish skills
and a solid background in Western European History) - This is a hands-on course; in addition to
classroom lectures much time is also spent in the city looking at historical monuments, ruins, walls,
churches, museums, etc., using Sevilla as the laboratory for the classroom.
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Student Name: ________________________________________

II. Required Semester Courses: These courses will complete the 45 contact hours necessary for a 3
semester/4.5 quarter credit class.

Place an “X” before the 4 first choice courses** and indicate with an "A”, your 2 alternate courses. You may choose
any combination of CIEE Study Center Courses (ending with CSCS) and Cursos Para Extranjeros, (ending with
SECE), regular University of Seville and University of Pablo de Olavide courses. **Students who want to take
Cursos Para Extranjeros (SECE) must take a minimum of two. If you desire to take all your classes through
Cursos, then you are required to take 5 courses during the regular semester.**

A. CIEE Study Center Courses (CSCS) - Please note: a certain percentage on the on-site language exam will
be required in order to enroll in these courses.

______ SPAN 4102 CSCS: Advanced Composition and Stylistics


______ SPAN 4103 CSCS: Spanish for Students of Business and Economics
______ LITT 3101 CSCS: Contemporary Spanish Literature
______ HIST 3101 CSCS: Twentieth Century Spanish Political History
______ ECON 3101 CSCS: Contemporary Spanish Economic History
______ AHIS 3101 CSCS: Contemporary Spanish Art
______ INRE 3101 CSCS: European-Latin American Relations since Independence
______ INRE 3102 CSCS: U.S. –European Relations since World War II.
______ LITT 3102 CSCS: The Novel and the Cinema: Two Ways of telling the Story
______ SPAN 4104 CSCS: Translation: Practice and Theory
______ LITT 3103 CSCS: Women Writers in Twentieth Century Spain
______ SPAN 4105 CSCS: Comparative and Contrastive Syntax
______ SPAN 4106 CSCS: Spanish Phonetics and Phonology
______ SPAN 4107 CSCS: Advanced Spanish Syntax and Grammar
______ SPAN 4108 CSCS: The Meaning of Words: Spanish Lexicology and Semantics
______ LITT 3104 CSCS: Cervantes and El Quijote
______ BUSI 3101 CSCS: Protocol and Etiquette in Business and Foreign Affairs
______ INRE 3103 CSCS: Spain and European Integration
______ POLI 3101 CSCS: Transition to Democracy in Spain and Contemporary Spanish Politics
______ EDUC 3102 CSCS: Methodology of Teaching Spanish as a Foreign Language (ELE)
______ PSYC 3101 CSCS: Psychology of Learning a Second Language
______ LITT 3105 CSCS: Latin American and Spanish Literature of the Margins
______EDUC 3101 CSCS: Professional Teaching Development
______LITT 3106 CSCS: Survey of Andalusian Literature: From Al-Andalus to Post-Modernity
______FILM 3101 CSCS: Contemporary Spanish Film
______SOCI 3001 CSCS: Islamic Culture and Art in Muslim Spain
______SPAN 3101 CSCS: Introduction to Spanish Linguistics
______ INDE 3101 CSCS: Special Projects * NOTE: Your project proposal must be attached.

*If you are considering taking Special Projects (INDE 3101 CSCS) you must submit a detailed outline of your
study project, prepared in consultation with your advisor, by May 1st, 2004 to maritheresa.frain@ciee-spain.org.
Your academic advisor’s signature should appear on the proposal indicating approval. Due to the many difficulties
involved in making arrangements for Special Projects, you will not be permitted to enroll in this course if you do not
submit the required outline via email to the Resident Director who will approve your project. There is also an
additional cost associated with this course. The Special Projects fee is $600. If you decide to take this course,
please check the appropriate box below for billing of the Special Projects Fee:
1 Please check this box if the additional cost for course number INDE 3101 CSCS should be added to your personal bill
1 Please check this box if the additional cost for course number INDE 3101 CSCS will be paid by your institution.
PLEASE NOTE: If you check this box, your Study Abroad advisor’s signature below certifies this fee should be
included with the regular program fees that are billed to your school. This signature is only for the Special
Projects fee, NOT the entire course pre-registration form.
Study Abroad Advisor authorization for Special Projects fee:
Name: ____________________________________ Signature:_____________________________________
Email: ____________________________________
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Student Name: ________________________________________

B. Courses through "Cursos para Extranjeros" (SECE) –If you decide to take SECE classes you must
take at least two of these classes. The University does not allow you to take only one.

______SPAN 4101 SECE: Spanish Phonetics and Phonology


______SPAN 4102 SECE: Spanish Semantics
______SPAN 4103 SECE: Spanish Syntax
______SPAN 4104 SECE: Corrective Phonetics and Conversation
______SPAN 4105 SECE: Spanish Stylistics and Composition
______LITT 3101 SECE: Arabic Contributions and Influences on Spanish Literature
______CINE 3101 SECE: Contemporary Spanish Cinema
______ANTH 3101 SECE: Cultural Anthropology of Latin America
______HIST 3101 SECE: The Historical Projection of Three Cultures: Christians, Muslims, Jews in Medieval Spain
______SPAN 4109 SECE: Flamenco: Socio-Linguistic Expression of Andalusia
______ANTH 3103 SECE: Flamenco: Cultural and Anthropological Expression of Andalusia
______LITT 3001 SECE: Spanish Literature I, Middle Ages
______LITT 3003 SECE: Spanish Literature II, The Golden Age
______LITT 3005 SECE: Contemporary Spanish Poetry
______LITT 3007 SECE: Contemporary Spanish Drama
______LITT 3009 SECE: Intro. Textual Commentary and Literary Criticism (theory and practice)
______LITT 3011 SECE: The Contemporary Latin American Novel
______GEOG 3001 SECE: The Geography of Andalusia: Natural Resources and Landscapes
______SOCI 3001 SECE: Culture and Society in Contemporary Spain
______HIST 3001 SECE: Greece and Italy in the Classic Period
______POLI 3001 SECE: Intro. History of Modern Political Philosophies (18th-20th Centuries)
______HIST 3003 SECE: History of Modern Spain (1491-1833)
______AHIS 3001 SECE: Andalusian Art of the Golden Age
______AHIS 3003 SECE: Pre-Hispanic and Latin American Art
______AHIS 3005 SECE: Art of Islamic Spain
______HIST 3005 SECE: History of Spanish Colonization in America
______SPAN 4001 SECE: Spanish of Latin America
______SPAN 4003 SECE: Sociolinguistics of Andalusia
______HIST 3007 SECE: Pre-Hispanic American History

C. University of Seville/University Pablo de Olavide Courses: These are regular university classes with
Spanish students.
• Please contact resident staff via email concerning the availability of the classes which interest you:
lucia.quintana@ciee-spain.org and maritheresa.frain@ciee-spain.org. Final Registration will take place in
Seville after you have been properly advised.
• Liberal Arts students may only take classes in the Schools of Philology (www.siff2.us.es for class listings and
syllabi) and Geography/History at the Universidad de Sevilla and any classes from the facultades at the
Pablo de Olavide (www.upo.es).
• Please refer to the Spain catalog pages (Advanced Liberal Arts section) for a detailed list of courses that are
recommended. PLEASE CONFIRM WITH RESIDENT STAFF THAT THE CLASS YOU WANT IS
ACTUALLY BEING OFFERED DURING THE FALL SEMESTER.
• List below the title in Spanish of any regular university course(s) in which you plan to enroll
• When selecting these courses, choose fields in which you have a background. The Spanish university
system is much more rigid than in the United States and professors will assume that you have the same
background as the Spanish students. These courses are easy to add on once you are in Seville.
• Only students who are going to be in Seville for the academic year may register in yearlong classes.
*Final exams for regular university courses take place in late January/early February. You must stay until this
time if you want to receive a grade as exams may not be taken early.

NAME OF COURSE IN SPANISH: ____________________________________________________


UNIVERSITY: ____________________________________________________________________
NAME OF COURSE IN SPANISH: ____________________________________________________
UNIVERSITY: ____________________________________________________________________
NAME OF COURSE IN SPANISH: _____________________________________________________
UNIVERSITY: ____________________________________________________________________
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Student Name: ________________________________________

Please ensure your ACADEMIC ADVISOR has signed below, BEFORE submitting this form.

ACADEMIC ADVISOR MUST SIGN BELOW:


Attention Advisor: Signing this form indicates your approval for 7 courses selected by this student, for the
Fall 2004 semester:
• 1 required Intensive Language Session course
• 4 semester courses (5 if all SECE courses) that may be any combination of CSCS, SECE or
regular Universidad de Sevilla courses
• 2 semester alternate courses

Name (Please Print): _______________________________________________________

Signature: ______________________________________________________________

Institution: ______________________________________________________________

Telephone: _________________________________Fax: __________________________

Email: ________________________________________________________________
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Special Project Proposal Guidelines


Note: This is optional-you do not need to return this form if you do not plan to do a special project

Deadline: May 1, 2004

Working on a special project while in Seville can be an intellectually rewarding and stimulating
experience. We want to help you produce a solid proposal for consideration by resident staff. Please
work closely with your academic advisor to complete the following points. All details and agreements with
your university support must be completed before you arrive on site. Please have your advisor sign the
proposal and provide contact information. Please also send an electronic copy of the project proposals to
Dr. Maritheresa Frain by May 1, 2004 to maritheresa.frain@ciee-spain.org

There is a Special Project Fee of $600 for this course.

NOTE: Resident staff will review your proposal and decide how viable it would be to do in Seville.
Resident staff must approval all special projects.

Your proposal must address the following points:

1. Purpose (clearly stated and doable)

2. Methodology (how do you plan to go about doing your research/project?)

3. Resources (Spanish publications, web sites, reference materials)

4. Special needs (access to specific libraries, interviewing specific persons, in situ work
experience—hospital/clinic, art facilities, etc.)

5. Academic objectives (why do I want to do this class in Seville?)

6. Required work (what do I expect to do for this project?)

7. Grading (who is expected to give this grade and based upon what?)
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Spanish Visa Application Guidelines


Fall 2004
This information is VERY IMPORTANT. Be sure to read these instructions very carefully during
the visa application process.

PLEASE NOTE: Some Spanish Consulates are now REQUIRING students to go in person TWICE
to the Consulate-once to drop off their application and again to pick it up. These are new rules
and you MUST follow the instructions of the Consulate having jurisdiction over your permanent
address, regardless of the inconvenience and expense of traveling. CIEE cannot help you obtain
a student visa beyond giving you the following instructions and providing you with the required
letters.

A student visa is mandatory for any foreigner wishing to study in Spain for 3 months or longer. Each
CIEE student is responsible for obtaining his or her own visa and for any costs related to
obtaining the visa. The following general guidelines are accurate to the best of our knowledge.
Requirements, however, are subject to change without notice. Always use the instructions provided
by the Consulate. If they differ from our instructions, always use the Consulate’s instructions.
The application for a student visa is made at the Spanish Consulate having jurisdiction over the student’s
place of permanent residence. See end of this document for a list of Consulates and their jurisdictions.
You must IMMEDIATELY request a visa application upon being accepted to CIEE’s program. Do not
leave this until the last minute. Consulates have cut-off periods after which they will not accept visa
applications.
CIEE is not responsible for any problems you may encounter in obtaining a visa, nor can CIEE
intervene on your behalf with the Consulate. Spanish Consulates are strict and you must follow
their instructions EXACTLY.
Please note that the visa is processed in the student’s country of residence prior to departure. A student
visa cannot be acquired in Spain, nor can a student visa be sent to Spain. The visa is affixed in the
student’s passport by the Spanish Consulate before departure from the U.S., and must be presented to
border officials upon entry into Spain.
There are currently two types of visas that allow for study in Spain – the 180-day visa and the 90-day
visa.
The 180-day visa is for individuals who plan to study in Spain for a period of less than 6 months.
Individuals presenting this type of visa to border officials will be permitted to enter Spain for the purpose
of study for no more than 180 days (6 months). With the 180-day visa, the length of stay cannot be
extended. If there is any possibility that a student will want to study in Spain for a period of more
than 6 months, the student should enter Spain with a 90-day visa.
The 90-day visa is for students who plan a stay of longer than 6 months. Individuals presenting this
type of visa to border officials will be permitted to enter Spain for the purpose of study for an initial period
of 90 days. During this 90-day period, however, students (with the help of CIEE Resident Staff) work with
local authorities to acquire a student residency card. With this residency card, the student may remain in
Spain as long as he or she is enrolled in an academic program.
Due to the demand for student visas, it is important to allow enough time for the Spanish Consulate to
process a visa application. Start this process immediately as normal visa processing time is
between 4 to 7 weeks. Many Consulates will not accept applications less than 45 days before
departure.
IF YOU ARE NOT A US CITIZEN, contact the nearest Spanish Consulate IMMEDIATELY as there may
be different instructions for non-US citizens and it may take as long as three months to process a visa.
You might also have to apply for the visa in your home country.
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Please note that Consulates will not accept applications more than 90 days in advance and that, in many
cases, Consulates refuse to accept applications submitted less than 4 weeks prior to the student’s
departure date. In general, please be sure to apply early, and take into account that visa processing
times get longer as holiday periods approach.
Although there are certain exceptions, a personal appearance is usually required to submit a student visa
application. Some Consulates may accept applications by mail. YOU MUST CHECK THE
REQUIREMENTS OF THE CONSULATE YOU ARE USING.

Specific visa application procedures vary slightly from Consulate to Consulate, so for up-to-date and
accurate instructions, it is imperative that you check directly with the Consulate having jurisdiction over
your place of residence. You must follow the instructions the Consulate provides with the application.
The following documents are normally required for the student visa application. Again, you need to follow
the instructions provided by the Consulate. Please note that documents must be originals (not
photocopies). In addition to the original documentation, you’ll need at least two or three
photocopies of everything submitted.
• Application for Schengen Visa – four copies are normally required. You must request the
“Application for Schengen Visa” form by mail directly from the Spanish Consulate that has
jurisdiction over your permanent place of residence. You cannot request the application by fax.
If you are applying for the visa at the New York, Boston, or Washington, DC Consulates, you can
download the visa application form and visa instructions from each Consulate’s website. Please
refer to the list of the Spanish Consulates included below. If you are writing a letter to request the
application form by mail, ask the Consulate to send the application to your permanent address.
State that you are a student planning to study abroad in Seville, Alicante, Alcalá de Henares or
Barcelona as a part of an undergraduate/graduate degree and that you will be taking Spanish
language, literature, and content courses taught in Spanish. Include a self-addressed return
envelope with postage. Request an application IMMEDIATELY upon being accepted into the
CIEE program.
• Passport valid for a minimum of 6 months. Make sure your passport is signed. Also, please note
that the original passport is left with the Consulate while the application is being processed. If
you do not have a passport yet, you need to apply for one IMMEDIATELY. You should pay
to have the passport expedited to have it as soon as possible.
• Once your application is processed, the Consulate MAY return your passport to you via postal
service, you must check with them. For express delivery (highly recommended), you must
provide a US Postal Service Express Envelope with the appropriate postage and a completed
air bill. Other express delivery services and/or certified or registered mail are not accepted.
Tracking of mailed items is the responsibility of the applicant. Some Consulates will cover the
cost of returning the passport via regular mail, but you still need to submit a self-addressed
business sized envelope.
• Four recent pictures, passport size (stapled on each copy of the application). Digital photos,
senior pictures cut down to size or photocopies of other pictures are not acceptable. These must
be official passport photos.
• Original letter addressed to the Consulate verifying enrollment as a full-time student in an official
University or School in Spain, and verification of full payment of tuition. For this purpose, CIEE
program participants will receive a notarized “To the Spanish Consulate” letter and a letter
from the University in Spain. These letters will be sent to you together within two weeks
of your acceptance. They will be sent to the valid current address you supplied in your
application.
• If the applicant is not a citizen of the United States, the applicant must bring his/her “green card”
or other immigration documents (I-20 form, IAP-66, etc).
• Proof of health insurance coverage during your stay in Spain (contained in the letter that CIEE
will send you).
• Original medical certificate typed on doctor’s stationary/letterhead verifying that the applicant is
free from the following diseases: yellow fever, cholera, and the plague and/or any other
diseases specified in the Consulate’s instructions. The certificate must also certify that the
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

applicant is free of drug addictions and mental illness. These items must be specified and the
letter must be signed by a medical doctor. This is not the same thing as the CIEE Medical Report
Form.
• Those students who will stay longer than 6 months in Spain must bring a police record or a
“certificate of good conduct” issued by the police department of the city (or cities) where the
student has spent a period of 6 months or more during the last five years. Some Consulates
require this document regardless of length of stay.
• You may have to supply a copy of your flight itinerary. Some Consulates require your actual
airline tickets or proof of payment if it is an e-ticket. Check with the Consulate you are using.
• You must also submit one (although certain Consulates may require more than one) of the
following items to guarantee living expenses while in Spain:
o Letter from the study abroad program assuming full financial responsibility for tuition,
room and board for the student during his stay in Spain. This letter must mention that you
will be eligible for credit towards your Bachelor’s or Associate’s Degree. CIEE will
provide you with this letter.
o Proof of having received financial aid or scholarship covering expenses for tuition, room,
board, and personal expenses during the stay in Spain (minimum of $350 per month).
o Notarized letter from parents assuming full financial responsibility for the student for at
least $350 per month of stay in Spain and photocopies of your parent’s last Income Tax
Return where you appear as a dependent (pages 1 & 2 of the 1040 form).
Technically, US citizens are not charged a fee for a student visa. A “handling charge” of $100 is,
however, is collected by the Consulate. This handling charge is set at the same rate as the processing
fee charged to Spanish students applying for a US student visa.
Acceptable forms of payment vary from Consulate to Consulate, often cash or money order ONLY. You’ll
need to check directly with the Consulate having jurisdiction over your application to find out what forms
of payment are acceptable. If you are not a US citizen, there may be additional costs.

Be sure to keep a copy for your own records of everything you send to the Consulate, including a copy of
your passport.

The following points are essential for the proper completion of the Spanish Visa application. You have
one chance to apply by mail—any mistakes or missing documents will result in the return of your
application and passport without the Visa and you may be required to apply in person.

• Once you have downloaded (or received by mail) the Application for Schengen Visa, complete
according to the instructions and sample form provided on the following pages AND those sent
to you by the Spanish Consulate (or provided on the Consulate’s website).
• The Application for Schengen Visa must be complete, correct, and signed where
appropriate. You must include all additional required documents and your passport must be
signed.
• Use black or blue ink and print in block letters.
• If applicable: When sending your application and documentation to the Consulate, use
Overnight or Express mail through the U.S. Postal Service and note your tracking number. DO
NOT send your passport to the Spanish Consulate via REGULAR MAIL. Spanish
Consulates WILL NOT accept Federal Express or UPS. Be sure to include a pre-paid self-
addressed express envelope (note the tracking number on this as well) for the Consulate to mail
back your passport and visa when complete.
• Make sure you have included ALL of the necessary documents with your visa application.
• Make sure that your permanent address (not school or summer address) is on everything, the
application, the return envelope, etc. The Spanish Consulates will not send mail to any address
outside of their jurisdiction.
• If you are having a problem or have particular circumstances, it is best to fax the Consulate with
your question or concern (be sure to include your phone number and a return fax number). It can
be very difficult to reach them by telephone.
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Most importantly, be patient, persistent and respectful when speaking with the Consulate. They receive
many student visa applications each semester and are often understaffed. Furthermore, there is no
legal right to a visa.
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Spanish Consulate Locations:


If your permanent Contact the following Consulate: If your permanent address is Contact the following Consulate:
address is in: in:
Boston New Orleans
Maine, 545 Boylston St., Suite 803 Alabama, Arkansas, Louisiana, 2102 World Trade Center
Massachusetts, New Boston, MA 02116 Mississippi, Tennessee 2 Canal Street
Hampshire, Rhode Phone: (617) 536-2506/2527 New Orleans, LA 70130
Island, and Vermont
Fax: (617) 536-8512 Phone: (504) 525-4951/7920
Email:conspbos@mail.mae.es Fax: (504) 525-4955
Website:www.spainconsul- Email:conspneworleans@mail.m
ny.org/boston.html ae.es
From June 15-Sept 15 and Nov
15-Jan 15 appointment is
required. / Office Hours: Mon-Fri
9am-12 noon
Chicago New York
Illinois, Indiana, 180 North Michigan Avenue, Connecticut, Delaware, New 150 East 58th St, 30th Floor
Iowa, Kansas, Suite 1500 Jersey, New York, and New York, NY 10155-0080
Kentucky, Michigan, Chicago, IL 60601 Pennsylvania Phone: (212)
Minnesota, Missouri,
Nebraska, North Phone: (312) 782-4588/4589 355-4080/4081/4082/4085
Dakota, Ohio, South Fax: (312) 782-1635 Fax: (212) 644-3751
Dakota, and Email:cgspain.chicago@mail.ma Email:spainconsulny@mail.mae.
Wisconsin e.es es
Website:http://www.consulate- Website:www.spainconsul-ny.org
spain-chicago.com/

Houston Puerto Rico


New Mexico, 1800 Bering Drive, Suite 660 Puerto Rico, Islands of Edificio Mercantil Plaza,
Oklahoma, and Houston, TX 77057 Culebra and Vieques, and U.S. Avda. Ponce de León s/n,11th
Texas Phone: (713) Virgin Islands Floor
783-6200/6205/6214 Hato Rey, PR 00919
Fax: (713) 783-6166 Send correspondence to:
Email:consulatespain@houston.r Aptdo Postal 9243
r.com Santurce, PR 00908
Phone: (787)
758-6090/6142/6279
Fax: (787) 758-6948
Email:cgesp.pr@correo.mae.es
Los Angeles San Francisco
Arizona, Colorado, 5055 Wilshire Boulevard, Suite Alaska, California (except 1405 Sutter Street
and Utah; In 960 Southern counties –see Los San Francisco, CA 94109
California the Los Angeles, CA 90036 Angeles), Hawaii, Idaho, Phone: (415) 922-2995/2996
counties of Imperial, Montana, Nevada, Oregon,
Phone: (323) 938-0158/0166 Fax: (415) 931-9706
Inyo, Kern, Los Washington State, Wyoming,
Fax: (323) 938-2502 Email:conspsfo@mail.mae.es
Angeles, Orange, Pacific Islands territories of the
Riverside, San Email:consplax@mail.mae.es USA
Bernardino, San
Diego, San Luis
Obispo, Santa
Barbara, and Ventura
Miami Washington, DC
2655 Le Juene Road, Suite 203 Maryland, North Carolina, 2375 Pennsylvania Ave NW
Florida, Georgia, Coral Gables, FL 33134 Virginia, Washington D.C., and Washington, D.C. 20037
and South Carolina Phone: (305) West Virginia Phone: (202) 728-2330
446-5511/5512/5513 Fax: (202) 728-2302
Fax: (305) 446-0585 Email:cgspaindc@mail.mae.es
Email:cgspain.miami@mail.mae. Website:www.spainemb.org/consul
es ado/consuladoSpanish.html
Website:http://www.conspainmia
mi.org/
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Line by line instructions for the “Application for Schengen Visa”:


*REMEMBER TO WRITE IN CAPITAL LETTERS IN BLUE OR BLACK INK*
Line # They ask for: You should answer:
1 Apellido(s)/Surname(s)(family name(s)) Your last name
2 Si ha lugar, apellidos de soltera/Surname(s) at birth Maiden name if applicable
(earlier family name(s))
3 Nombre/First names (given names) First name
4 Fecha de nacimiento (año-mes-día)/Date of birth Year/Month/Day of your birth
(year-month-day)
5 Número del documento de identidad (optativo)/ID- Leave blank
number (optional)
6 Lugar y país de nacimiento/ Place and country of Name of your birth State and Country of
birth birth (i.e. California, USA)
7 Nacionalidad(es) actuales/ Current nationality/ies “US” or your nationality as applicable
8 Nacionalidad de origen (nacionalidad por “US” or your nationality when you were
nacimiento)/Original nationality (nationality at birth) born.
9 Sexo/Sex Circle one
10 Estado Civil/Marital status Circle the appropriate one
11 Nombre del padre/Father’s name Write your father’s full name
12 Nombre de la madre/Mother’s name Write your mother’s full name
13 Tipo de pasaporte/Type of passport Circle “National passport” unless you
have something else
14 Número de pasaporte/Number of passport Write passport number
15 Expedido por/Issued by “USA” or other as applicable
16 Fecha de expedición/Date of issue Date of issue
17 Válido hasta/Valid until Write date that your passport expires
18 Si no reside usted en su país de origen, ¿se le Leave blank, or answer “no” or “yes” as
permite el regreso al país en que reside?/If you applicable.
reside in a country other than your country of origin,
have you permission to return to that country
19 Ocupación actual/Current occupation Write “Student”
20 Nombre, dirección y número de teléfono de la Write the name and address of your home
empresa para la que trabaja. Para los estudiantes, university
nombre y dirección del centro en el que estudian /
Employer and employer’s address and telephone
number. For students, name and address of
school.
21 Destino principal/Main destination The city where you will be studying (i.e.
Seville, Alcalá, Alicante, or Barcelona)
22 Tipo de visado/Type of Visa Circle “Corta duración/Short stay” if you
are staying in Spain for less than six
months. Circle ‘Larga duración/Long
stay” if you are staying in Spain for more
than six months.
23 Visado/Visa Circle “Individual”
24 Número de entradas que solicita/ Number of entries Circle “Entradas múltiples/Multiple
requested entries”
25 Duración de la estancia/Duration of stay Write the type of visa you are applying
for– 90 or 180 days (read notes above for
information on these two types).
26 Otros visados (expedidos durante los tres últimos Answer if applicable
años) y período de validez de los mismos/Other
visas (issued during the past three years) and their
period of validity
27 En caso de tránsito, ¿tiene permiso de entrada en Leave blank
el ultimo país de destino?/In the case of transit,
have you an entry permit for the final country of
destination?
28 Anteriores visitas a éste u otros Estados Answer as applicable
CIEE Study Center at University of Seville, Seville, Spain
Liberal Arts Program, Fall 2004

Schengen/Previous stays in this or other Schengen


states
29 Finalidad de viaje/Purpose of travel Where it says “Other (please specify)”
write “Academic reasons.”
30 Fecha de llegada/Date of arrival Write the day that you plan to arrive in
Spain
31 Fecha de salida/Date of departure Your projected return date (it does not
have to be a definite date, just the date on
which you may return)
32 Frontera de primera entrada o itinerario de Write the country from which you are
tránsito/Border of first entry or transit route entering Spain (either the US or other).
33 Medio de transporte/Means of transport Plane or other if applicable
34 Name Write CIEE and Name of your Resident
Director (see the Program Details page
on the enrollment website for this
information)
Telephone and fax Write the number of the CIEE office
where you will be studying
Full address Write the address of the CIEE office
where you will be studying
Email address Write the email address of your Resident
Director
35 ¿Quién paga los gastos de viaje y los gastos de Write “CIEE”
manutención del solicitante durante la estancia?
/ Who is paying for your cost of travelling and for
your costs of living during your stay?

36 Medios de subsistencia durante la estancia / Circle applicable means of support for you
Means of support during your stay and where it says “Other” write “CIEE-
Sevilla”, “CIEE-Alcalá”, “CIEE-Barcelona”
or “CIEE-Alicante”. Write the name of the
health insurance that appears in your visa
letter. The insurance is valid until two
weeks after your program ends.
37--41 Fill out if you have a spouse
42 Leave Blank
43 Leave Blank
44 Leave blank
45 Domicilio personal del solicitante / Applicant’s Use your PERMANENT address
home address

46 Teléfono/Telephone number Your phone number


47 Lugar y fecha/Place and date Place and date when you are completing
this form.
48 Firma (en el caso de los menores, firma del Your signature
responsible o tutor) / Signature (for minors,
signature of custodian/guardian)