FULLERTON COLLEGE & CYPRESS COLLEGE - Study Abroad



STUDY ABROAD APPLICATION INSTRUCTION SHEET

Following is a list of the required materials to be attached to your application packet Turn in your completed application packet (exceptions for items noted with an * if they do not pertain to you) to:

Kristen Wiederholt

Library, Room 823

1. NOCCCD Application:

To reserve a spot for programs, you must turn in the NOCCCD application, essay and unofficial transcripts. All other paperwork will need to be turned in once program opens and/or once you have been accepted.

2. Unofficial Transcript(s): From all colleges and universities attended.

3. * English 100 Verification form: If your English 100 class (or equivalent requirement) was taken at any college or university other than Fullerton College or Cypress College, you must submit the form with your application packet. The form is on the study abroad website: . Set up a meeting or email FC counselor, Nahrin Hinaro, nhinaro@fullcoll.edu, with your transcripts so she can verify that it is equivalent to FC English 100 class. Attach your email verification from her with your form.

4. * Student Acknowledgement of Liability form: If you have not met all the requirements, you must complete and sign the form, and turn in the form with your application packet. The form is on the study abroad website:

5. One photocopy of the information page of your passport (that is the page with your picture on it). (Note: This item may be submitted separately, if you have not received your passport yet. If you have not applied for your passport yet, it is very important that you apply immediately.)

6. One passport photo headshot: Must be printed on photo paper with white background. Photo dimensions are 2in x 2in. Paper clip to application upper right hand corner, do not staple.

7. Vendor Application Online: To be completed once you have been accepted into the program.

8. Deposit: To be turned in once accepted into the program.

Submit above required materials at one time. Any application packet with missing items will be considered incomplete and will not be accepted.

*(Except as noted above if it does not pertain to you–does not delay application for these particular items)

FULLERTON COLLEGE & CYPRESS COLLEGE

STUDY ABROAD APPLICATION

Prerequisites: A minimum of 12 semester units must be completed prior to applying for Study Abroad. English 100 or equivalent must be completed with a grade of “C” or better the semester before you leave, to apply for this Study Abroad Program. A grade point average (GPA) of 2.5 is required at the time of application. Applicant must be 18 years of age prior to the start of the semester.

Program you are applying for: _____________________________________________________

Correspondence Information:

1.) Name:

_______________________________________________________________________________

(First) (Middle Initial) (Last)

Student ID #: _____________________________

(Check One): □ Male □ Female (Check One): □ Fullerton □ Cypress □ Other

2.) Current Street Address: ___________________________________________________________

City: ___________________________________ State: _____ Zip Code: ____________________

Phone: _________________________________

3.) Permanent Address (e.g.; address of parent, guardian, or spouse)

Street Address: __________________________________________________________________

City: ___________________________________ State: ______ Zip Code: __________________

Phone: ________________________________

4.) Will you be 18 years of age prior to the Study Abroad Semester? (Check One): □ Yes □ No

5.) Birthdate: _______________________________________________________________________

6.) E-mail address (please print distinctly): _____________________________________________

7.) College or school you are presently attending: __________________________________________

Medical Information:

We do not require a physician’s report as a condition of acceptance in the program, but we strongly recommend that you have medical and dental checkups before going abroad. If you have a specific physical and/or mental health problem of which we should be aware, you are required to inform the Program Coordinator in writing before departure so that your study abroad experience will be as safe and as comfortable as possible. We keep this information in the strictest of confidence and do not use it for admission purposes.

Please be aware that the stress of travel and adjusting to a new culture can exacerbate physical or psychological conditions that may be under control at home. Therefore, if you have a physical or psychological condition, it is important that you meet with your physician or counselor to discuss how studying off campus could affect your medical condition. Addressing your health issues prior to studying off campus will help you to identify those resources that will and will not be available at your program site.

General Information:

8.) Academic Status (Check One): □ Freshman □ Sophomore □ Junior □ Graduate □ Other

9.) Do you expect to be traveling on a U.S. passport? (Check One): □ Yes □ No

If not, from which country? ______________________________________________________________

10.) Academic or prospective major: _______________________________________________________

11.) Total number of college units completed to date: _____________ Cumulative GPA: ____________

12.) Please list all colleges attended:

13.) Have you taken English 100 or an equivalent? (Check One): □ Yes □ No □ In Progress □ AP class

Grade: ______ *If your English 100 or equivalent requirement was taken at any college or university

other than Fullerton College or Cypress College, submit the “English 100 Verification” form, signed by Counseling.

Submit a copy of all transcripts with this application. Unofficial transcripts are acceptable, including printouts from Webstar.

Essay

14.) On a separate piece of paper, to be submitted with NOCCCD application. (Applications missing the essay will not be accepted):

Describe two specific goals you would like to meet through your study abroad experience on this program, and explain how you will do this. Please rank these goals with the most important first. These two responses together should be approximately one page long (typed, double-spaced).

Academic References:

15.) Please provide the names and contact information for two academic references:

Name: ____________________________________ School: __________________________________

Position: ___________________________________ Phone Number: ___________________________

E-Mail address: ____________________________________________

Name: ____________________________________ School: __________________________________

Position: ___________________________________ Phone Number: ___________________________

E-Mail address: ____________________________________________

16.) For our records, please tell us how you found out about this program.

 

□ Classroom Presentation

(presenters name, if known) _____________________________________________________

(class name, if known) __________________________________________________________

□ Posters around Campus

□ Quad Event (please state which one) ___________________________________________________

□ Study Abroad Website

□ Other (please state) _________________________________________________________________

17.) Should I be accepted into this Study Abroad Program, I give the Study Abroad Program permission to include photos of me on their website and promotional materials. (Check One): □ Yes □ No

I have read and understand the above statements: (Check One): □ Yes □ No

I affirm that the information given in this application is true and correct to the best of my knowledge. I also give permission for NOCCCD to contact the above-noted references regarding my academic record.

____________________ ______________________________________________________________

(Date) (Applicant Signature)

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