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 firstname.lastname@example.org Name ___________________________________________________________
it appears on your passport)
q Female q Male
Date of birth (m/d/y)
Current grade (9-12)
Country of citizenship
Home fax _______________________________
Work telephone _______________________________________
Work telephone ______________________________________
Name and address of the school you now attend _________________________________________________________________
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) ___________
Signature of parent or guardian
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?
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 email@example.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.