Application for ��AV in Rome

Along with this application, please provide:

Most recent transcript (Students can download an unofficial transcript in PDF format from . Go to 'Student Information', then click the 'Documents' tab. Find the most recent document titled "Unofficial ��AV Transcript" and click 'Download'. You can upload the transcript to this application in the 'Documentation' section below.
Copy of the photo page of your passport

* Required field

Student Personal Information

Surname/Primary name *

Given name *

Passport name *

Gender

Age

Date of birth

Place of birth

Nationality/Citizenship

Country of residence

Passport #

Passport valid until

Student health insurance plan *

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Other

Student Contact Information

Applicant’s home/permanent address
Include street address, apt/unit if applicable, city, state/province, country and zip code.

Mobile phone

Email *

Applicant’s emergency contact
Parent, guardian, or other person able to make legal and medical decisions on the student’s behalf.

Name

Address

Mobile phone

Self Description

Previous experiences abroad
Please describe previous travel experience outside the US, if any.

Personal statement
Please tell us why you are interested in the ��AV in Rome program, and what you hope to gain from the experience.

Living abroad
If accepted, you will be living in close quarters and studying intensely with other ��AV students nearly 24 hours a day for 10 days. Please address how you might handle the challenges of such a situation. If possible, cite a specific example of how you handled an intense social environment in the past.

Documentation

Please provide your most recent transcript (see instructions above), and a copy of the photo page of your passport. All provided documentation will be handled securely and access limited as per the ��AV Data Privacy Policy.

Maximum file size is 10mb; .pdf, .doc, .docx, .png, or .jpg only. Please check the format and size of your document before uploading.

Document

Assumption of Risk, Release from Liability, and Indemnification Agreement

Please read the ��AV-Sponsored Study Abroad Programs Assumption of Risk, Release from Liability, and Indemnification Agreement and indicate below that you agree to the terms.

* By checking this box, I am indicating that I have read and understand and agree to all the terms and conditions in the above agreement.

By submitting this form, I confirm that the above information is true and correct.

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International Programs Office