NW CADIZ
PROGRAM

APPLICATION FOR STUDY AT CADIZ, SPAIN

================

APPLICATION DEADLINES:  For Fall Semester or full year March
20.  For Spring Sem. Oct. 20. The entire application file
(including recommendations) must be COMPLETE AND RECEIVED (not merely posted)
by deadline day. Note that UW mail delivery over quarter breaks is limited and
may take days.  See list of required application materials.

INSTRUCTIONS:

Complete this form (please type or print carefully, especially
your email address).

Attach a copy of your complete college transcript (UW students:
unofficial transcript is acceptable.) and personal statement (see below).

Attach a check for $100, payable to University of Washington.
This application fee is NOT refunded if the student withdraws after having
been accepted into the program.

UW students should turn in their application materials to
Padelford C-104. Students from schools other than UW, WWU, should send the
materials to: NW CADIZ Program -- UW, Box 354360 --Seattle, WA 98195-4360.

Request letters of recommendation from two professors who know you
well (one must be from a college level Spanish instructor). Have these
letters sent to above address or to your campus coordinator.

NAME ____________________________________________________ SEX
_____________

DATE OF BIRTH ___________________________  CITIZEN OF ____________________

YOUR UNIVERSITY/COLLEGE ________________________________YEAR (jr,so...)
____________

STUDENT # ________________ MAJOR(S) _________________________________________________

SEMS/QTRS OF SPANISH STUDIED  ______  1st
LEVEL IN CADIZ
(circle 1) 301, 302, 303, 406

STATE OF HEALTH ______________ SPECIAL NEEDS?_____________________________________

SEMESTER(S) YOU WISH TO STUDY IN CADIZ (fall/spr/yr-include
yr) _______________________

TWO RECOMMENDATIONS FROM: _________________________
__________________________

PRESENT ADDRESS ____________________________________________________________________

E-MAIL____________________________________________________
PHONE_____________________

PERMANENT ADDR ____________________________________________
PHONE ________________

EMERGENCY
CONTACT:__________________________________ RELATIONSHIP _____________

ADDRESS ______________________________________________________ PHONE_________________

SIGNATURE ___________________________________________________
DATE __________________

ON A SEPARATE SHEET, TELL US SOMETHING
ABOUT YOUR ACADEMIC AND PERSONAL INTERESTS & YOUR REASONS FOR WANTING TO
STUDY WITH THIS PROGRAM IN CADIZ (Spanish preferred; English accepted).

Review of Disciplinary Records

Policy:  The University of Washington
reviews students’ disciplinary records when evaluating applications for a
study abroad educational activity. Students not accepted to a study abroad
activity based on disciplinary records have the right to appeal.

For more
information about this process, please contact the UW Community Standards and
Student Conduct Office at (206) 685-6194.

I have
read and understand the policy on the review of disciplinary records.

_________________________________________________________________________

Student’s Signature                                                                                Date