JEEP Application Application for Semester - Select -Fall 2015 (August-December)Academic Year 2015-2016 (August-May)Spring 2016 (January-May)Fall 2016 (August-December)Academic Year 2016-2017Spring 2017 (January-May) Partner Institution - Select -American College of Greece DEREE (Greece)Ateneo University (Philippines)Changwon National University (Korea)Chinese University Hong Kong (China)Fu Jen Catholic University (Taiwan)HAAGA-HELIA University of Applied Sciences (Finland)Hong Kong Baptist University (China)Hong Kong Polytechnic University-SHTM (China)Hotel Management School Maastricht (Netherlands)Koc University (Turkey)Management Center Innsbruck (MCI Austria)Mary Immaculate College (Ireland)Pontificia Universidad Catolica del Ecuador (Ecuador)Pontifica Universidad Javeriana Bogota (Colombia)Pontifica Universidad Javeriana Cali (Colombia)Pontificia Universidad Catolica de Rio de Janiero (Brazil)Pontificia Universidad Catolica do Rio Grande do Sul (Brazil)Ritsumeikan University (Japan)Sciences Po (France)Sogang University (Korea)Sophia University (Japan)St. Mary's University College (England)St. Xavier's College in Mumbai (India)Tibet Fund (Tibet)TSI Sant Ignasi BarcelonaUniversidad Alberto Hurtado (Chile)Universidad Catolica Argentina Buenos Aires (Argentina)Universidad Catolica de Cordoba (Argentina)Universidad Catolica del Uruguay (Uruguay)Universidad Centroamericana Managua (Nicaragua)Universidad Iberoamericana, Puebla (Mexico)Universidad Iberoamericana, Mexico City (Mexico)Universidad Iberoamericana, Tijuana (Mexico)Universidad del Pacifico (Peru)Universidad Loyola Andalucia (Spain)Universidad Pontificia Comillas (Spain)Universita Cattolica del Sacro Cuore (Italy)Universitat Ramon Llull Institut Quimic de Sarria (Spain)Universite Catholique de Lille (France)Universite Catholique de Lille IESEG (France)University of Notre Dame (Australia) Name (As it appears on your passport) Last First Middle Other name on supporting documents Permanent Mailing Address (Foreign Address) Street City State Country Postal Code Phone Number Email Address Current Mailing Address Street City State Country Postal Code Phone Number Email Address Academic Interest College - Select -Arts & SciencesSchool of Management Major Personal Information Date of Birth City of Birth Country of Birth Gender Male Female Marital Status - Select -SingleMarried Ethnic Background - Select -AsianBlack Non-HispanicLatino/Hispanic/ChicacoMulti-Ethnic (please specify)Native American or Alaskan NativeNative Hawaiian or Pacific IslanderWhite Non-HispanicOther, please specify Multi-Ethnic or Other If Multi-Ethnic or Other, please specify: Religious Preference - Select -BuddhistCatholicHinduJewishMuslimProtestantNo ReligionOther Primary Language Spoken at Home Are you a U.S. Citizen Yes No Country of Citizenship If no, what is your country of citizenship? Country of Nationality Visa Alternative Text Most Jesuit Exchange Program applicants will apply for a J-1 (Exchange Visitor) Visa. If you plan on using a different non-immigrant visa, please list it below: Visa Alternative Have you ever been convicted of a criminal offense? - Select -YesNo Reason for Criminal Record If yes, please explain Have you been inside the U.S. within the preceding 12 months? - Select -YesNo INS/US Department of State documents (If yes, please note that you must provide, with this application, copies of all INS/US Department of State related documents in order to determine eligibility for J-1 status at USF. Send documentation to email@example.com.) US Visits Please include dates of visit(s) and city or cities visited. US Visit 1. Dates in U.S. Immigrant Status US Visit 2. Dates in U.S. Immigrant Status US Visit 3. Dates in U.S. Immigrant Status Previous J-1 Visa Status - Select -YesNo DS-2019 If yes, please send copies of all previous DS-2019 forms to firstname.lastname@example.org. Academic Background Universities Attended Universities/Institutions Attended: (List all post-secondary [tertiary level] schools beginning with school currently or most recently attended) University/Institution 1. Name City/State/Telephone Number Date Attended From To University/Institution 2. Name City/State/Telephone Number Date Attended From To University/Institution 3. Name City/State/Telephone Number Date Attended From To Emergency Contact/Family Information Emergency Contact 1. Full Name Relationship Address Phone Number Email Emergency Contact 2. Full Name Relationship Address Phone Number Email Siblings Applicant's Siblings/Children (if any) Sibling 1. Name Relationship Sibling 2. Name Relationship Sibling 3. Name Relationship Relatives Attending USF If any of your relatives have attended/are attending USF, please list their names, relationship to you, and year of graduation By checking this box, I hereby certify that all the information I provided on this JEEP Application Form is true and correct.