Non-Student Study Abroad Application

Application for Non-Students

Name (First and Last)

Phone Number

Address

City/Town

State/Province

ZIP/Postal Code

Relationship to UVA Wise

Citizenship(s)

Have you traveled outside of the United States?

Where have you visited?

Desired study abroad country and/or program

Term for study abroad experience

Emergency Contact Information

Please list name, address, phone, email and relationship for two emergency contacts.

List any allergies or dietary needs

CAPTCHA

Math question 7 + 9 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

Have you reviewed and completed recommended vaccinations by the CDC?

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