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Summer Programs Abroad |SPAIN Application for Admission Sergio Carranza Summer in Spain The Loomis Chaffee School 3340 81st Street #32 Jackson Heights, NY 11372 Telephone  718.639.1327 Facsimile  646.895.7602 Email  summerinspain@gmail.com Name ___________________________________________________________

(as

it appears on your passport)

Gender

q Female q Male

Home Address

___________________________________________________

Date of birth (m/d/y)

_________________

___________________________________________________

Current grade (9-12)

_________________

___________________________________________________

Country of citizenship

_________________

___________________________________________________

Telephone

___________________________________________________

Email

___________________________________________________

Home fax _______________________________

Parent/guardian _______________________________________

Parent/guardian ______________________________________

Work telephone _______________________________________

Work telephone ______________________________________

Email

Email

_______________________________________

______________________________________

Name and address of the school you now attend _________________________________________________________________

_________________________________________________________________

_________________________________________________________________

Check one

q Day student

q Boarding student

Name and address of the school you will attend _________________________________________________________________ after the summer program (If different)

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

(Ex. Sp 2 Adv. or Fr 3 Reg.)

Current language class, year and level

Name of current language teacher

Term grade for the most recent marking period

Signature of student

_______________________________________

_________________________________________________________________

(A, B, C, D, E, F) ___________

Date

_____________________________________________________

Signature of parent or guardian

Date

_______________________________________________________

Please complete questions on the back of this form.


1 Have you ever travelled to or lived in a country other than the United States?

If yes, please elaborate briefly. Have you used your foreign language skills outside of the classroom?

q

Yes q No

2 In a short essay, please discuss your reasons for wishing to participate in the Loomis Chaffee Summer Programs Abroad and discuss the goals you hope to achieve through your overseas experience with us this summer. Attach separate sheet if necessary.

3 In Spanish, please briefly describe one of the things you like best about your foreign language studies.

(Brevemente describa lo que le gusta más de sus estudios del español.)

4 Do you have any dietary restrictions which we should be aware of for placement in a host family? If yes, please describe.

Application checklist: In addition to this form please be sure to submit:

— $25 application fee (waived for Loomis Chaffee Students); — Confidential teacher’s recommendation form from your current language teacher; — Confidential adviser’s recommendation form from your adviser (or a teacher who knows you well); — A recent copy of your official high school transcript.

All forms should be sent to: Elyse Lau Summer in Spain The Loomis Chaffee School 3340 81st Street #32 Jackson Heights, NY 11372 Telephone  718.639.1327 Facsimile  646.895.7602 Email  summerinspain@gmail.com

All application materials should be received by May 1. The programs are filled on a first-come, first-served basis with qualified applicants. To ensure availability, please apply early.

APPLY FOR SUMMER IN SPAIN 2009  

THIS IS THE APPLICATION FORM TO ENROL IN SUMMER IN SPAIN 2009

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