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Basic Information
Current Address
1234 Place Street
Permanent Address (parents)
1234 Place Street
Academic Information
If you are an art history major, you may not have taken all ARTZ courses listed here. You are still able to apply to the program.
Please list the courses, semester taken and grade.
Financial Information
Terms and Conditions: 
I assume the risks of personal injury while attending the semester in Italy program in the School of Art. I permit the School of Art to arrange such emergency care as it may deem necessary. I will allow the involved hospital and/or doctor to administer the required treatment of the emergency condition. I also understand that all incurred costs are my responsibility.

Student Responsibility 
You are expected to participate in all School of Art activities. You are expected to stay in the room to which you are assigned. You must comply with the directions of School of Art faculty. You are responsible for and will be billed for any damages or missing property. You are, at all times, responsible for your own conduct and safety. You will assume all risks of personal property damage or loss. Registrations may be revoked if the student is involved in a documented discipline incident during the program. Failure to cooperate and conduct yourself in a manner consistent with these rules may jeopardize the program, your welfare, and the welfare of others. The University reserves the right to send you home at your expense if it is determined, at the University’s discretion, that it is in your best interest, other participant’s, and/or the School of Art’s best interest.*

We appreciate your consideration. We feel confident that your time in this program will be meaningful, worthwhile experience. Please sign below for indication of your agreement with the policies stated above.