Application for Admission 2018 International Center for Study and Research PERSONAL INFORMATION

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1/6 PHOTO Universidad San Ignacio de Loyola Av. La Fontana 550, La Molina Tel. (51-1) 317-1000 Ext. 3220 Fax. (51-1) 317 1059 www.usil.edu.pe Application for Admission 2018 International Center for Study and Research PERSONAL INFORMATION Family name: First name: Full name according to passport : Passport number: Date and place of birth: Day Month Year Place Nationality: Gender: Male Female Home address: City/State: Country: Phone(s): Zip Code: E-mail(s): HOME SCHOOL / INSTITUTION Home School / Institution: Academic Program / Major: Address: City/State: Country: Exchange contact: Phone(s): E-mail(s): Zip Code: TRAVELING INFORMATION: Closest Peruvian consulate: Country Arrival date: City Accommodation: USIL Residence Family homestay Hotel / Hostel Other accommodation Signature Date PLEASE NOTE: Students must enter Peru on a TOURIST VISA if traveling independently or through an educational representative. If students arrive through a USIL partner university, they must enter Peru under an OFFICIAL VISA, which is requested from the immigration department by USIL and then sent to the consulate you have indicated above. Please do not apply for a student visa on your own.

Study Abroad Academic Planning Form 2018 International Center for Study and Research 2/6 Student s Name: Program: Semester in Cusco Summer in Cusco Faculty-led Customized program Name of customized or faculty-led program: Term abroad: January - May August - December Summer term (May-June) Summer term (July-August) Other term Dates of the program: From To Study program in your home institution: Major: Number of years study prior to arrival: COURSES: How many courses will you take? NB: For a 4-month semester students are permitted to take up to 5 courses. For a 5-week summer term students are permitted to take up to 2 courses. Please mark at least 8 options for a semester and at least 5 options for a summer term. Please, list your course choices by numbering next to the box. Example, 1= first choice, 2 = second choice etc. USIL will define your final course list by choosing from these options. PLEASE NOTE: Placement into courses is not guaranteed, as each course requires a minimum number of applications or there might be scheduling conflicts. Beginners Spanish* Pre-intermediate Spanish* Intermediate Spanish* Advanced Spanish* Comunicación escrita en español (taught in Spanish; advanced level of Spanish is required) Beginners Quechua (taught in Spanish; advanced level of Spanish is required) Literatura latinoamericana (taught in Spanish; advanced level of Spanish is required) History and Culture of the Incas (taught in English) Historia y cultura de los incas (taught in Spanish; advanced level of Spanish is required) Contemporary Society and Culture of Peru (taught in English) Sociedad y cultura contemporánea del Perú (taught in Spanish; advanced level of Spanish is required) Institutions in Peruvian Society (taught in English) Introduction to volunteering, service learning and social responsibility in Cusco (taught in English) Inca Architecture (taught in English) Cultural Heritage Conservation (taught in English) Conservación del patrimonio cultural (taught in Spanish; advanced level of Spanish is required) Art & Design in Cusco (taught in English) Photography in Cusco (taught in English) Business in Peru and Latin America (taught in English) International Trade: Import and Export (taught in English) Introduction to Communication (taught in English) Communication Psychology (taught in English) Communication for Development (taught in English) History of Latin American Cinema (taught in English) Historia del cine latinoamericano (taught in Spanish; advanced level of Spanish is required) Intercultural Communication (taught in English) Comunicación intercultural (taught in Spanish; advanced level of Spanish is required) Peru s Biodiversity (taught in English) Andean Nutrition (taught in English) Healing and Shamanism in Andean and Amazonian Cultures (taught in English) Economics and Sociology of Tourism (taught in English) Cultural Tourism in Cusco and Peru (taught in English) Participatory and Immersion Tourism in Peru (taught in English) Sustainable Tourism (taught in English) History of Peruvian Cuisine (taught in English) Gastronomic Tourism in Cusco and Peru (taught in English) * Level to be determined upon results of Spanish Placement Test administered by USIL. You can only take 1 Spanish course per term. Are any of these courses required as mandatory by your home university?

3/6 LANGUAGE SKILLS Spanish English Advanced Intermediate Preintermediate Preintermediate Beginners Advanced Intermediate Beginners Speaking Reading Writing Listening Other language skills: How did you learn about USIL? USIL website A current or former student at my home university USIL brochure At an education fair An educational agency / representative School advisor / International office An article in a magazine or newspaper Other: ENCLOSE: 1. Two (2) printed passport photos or a jpg file 800 x 600 px minimum. 2. Curriculum vitae (English or Spanish). 3. Transcripts and grade reports (English or Spanish). Students must have a minimum GPA of 2.7 (2.5 for CCIS students) or equivalent to be eligible for the program. 4. Motivation letter (English or Spanish). 5. Clear passport copy (passport must be valid for the entire period of your stay in Peru). 6. Copy of International Health Insurance valid for the entire period of your stay in Peru. IMPORTANT: This form cannot be processed without photos and a clear passport copy. If you do not enclose these, you will not receive your student card in time. I hereby confirm that the information I have given is correct and may be used for administrative purposes at the overseas university to which I have applied for an exchange. City and date Signature In accordance with Law N 29733 Law for the Protection of Personal Data and its Rulings approved by Supreme Decree D.S. 003-2013-JUS, the student gives his/her express consent for the personal data provided to be incorporated in the Students, Alumni, Parents and Legal Guardians of Students personal databank of San Ignacio de Loyola University (USIL) and for that information to be used with the purpose of providing an appropriate educational service or, in the case of alumni, for the issuance of certificates upon request, as well as for communicating information concerning new academic programs and institutional activities; such uses may include financial and accounting management activities, monitoring of compliance and lack of compliance with financial obligations and insurance service provision, the management of client lists, profile analysis, publicity and commercial prospection, statistical, historical and scientific activities, the rendering of communication and telecommunication services, the management of lists of associates, associative, cultural, leisure, sport and professional activities, education, medical records, video surveillance, security and control of access to facilities, and the issuance of reports. Furthermore, information provided may be subject to the local transference of data to organizations directly related to USIL, including but not limited to insurance companies, EPS, health centers, financial institutions, professional associations, educational institutions, institutions with inter-institutional cooperation agreements, institutions dedicated to job placement and/or labor market research, accrediting organizations, SUNEDU, the Ministry of Education and other public entities that may be related to the adequate provision of educational services; as well as in the international transference of students to foreign educational institutions in the case of students who participate in international exchange programs, visiting scholar or double degree programs. The student hereby authorizes USIL to maintain his/her personal data in the aforementioned databank after termination of this contractual agreement for as long as may be deemed useful for the abovementioned purposes and uses, and as part of compliance with relevant legal obligations. The student may exercise his/her right to access, update, rectify, oppose and suppress or cancel his/her personal data through INFOSIL or by downloading the PDP Rights Request form at www.usil.edu.pe/arco and sending it by e-mail to arco@usil.edu.pe, or submitting it in printed form at USIL s front desk, located at Avenida La Fontana 750, La Molina, Lima, Peru. Signature: Full name: Identity document number: Date:

Application for Extracurricular Educational Activities 2018 International Center for Study and Research 4/6 Family name: First name(s): I would like to participate in the following extracurricular activities offered by USIL: 1. VOLUNTEERING / SERVICE LEARNING PROGRAM I want to receive an official USIL Volunteering and Service Learning Program certificate (cost: US$ 220.00 for a semester and US$150.00 for a summer term. PLEASE COMPLETE AND SIGN THE LETTER OF COMMITMENT CONTAINED IN APPENDIX 1). I do not need an official USIL Volunteering and Service Learning Program certificate (no charge). Choose at least 3 of the Volunteering and Service Learning Program host organization(s) / institution(s) options listed below: CUSCO ANIMAL PROTECTION: Creating a website to promote fundraising; making of doghouses and kennels for puppies in a range of sizes; improving and repairing the roofs of the two animal shelters; installation of running water; participation in veterinary campaigns. CUSCO CENTER FOR TRADITIONAL TEXTILES: Assisting with Education Department events; organizing the photo archive and the permanent textile collection; creating an online database; conservation work with the permanent textile collection; assistance with texts for promotional publications, such as pamphlets and the bi-yearly newsletter, in Spanish and English; creating a catalog of CTTC products; designing a new CTTC website. VIRGEN DEL CARMEN RURAL SCHOOL (OCCOPATA VILLAGE): Greenhouse construction project; painting of recreation playground and school facilities; repair of classrooms and the kitchen; bilingual education (teaching English); science classes; recycling classes; library implementation. CASA DE ACOGIDA MANTAY (REFUGE FOR UNDERAGE SINGLE MOTHERS): Assistance with marketing and sale of handcraft products at the Mantay shop; creation of a handicraft products catalog; assistance with online sales of handcraft products; assistance with fundraising. MINISTRY OF CULTURE: Cleaning of archaeological sites; manufacturing and installation of preventive signs at archaeological sites; participation in campaigns to combat the illicit trafficking of cultural heritage. 2. COOKING LESSON This lesson is free of charge. Students need only pay for the cooking ingredients (not more than US$10 per person). 3. SALSA LESSONS These dance classes are free of charge. 4. EXCURSIONS (SEE DETAILS IN APPENDIX 2) Machu Picchu + Sacred Valley of the Incas + Inca fortified temple complex of Saqsaywaman + archaeological sites of Qenqo, Tambo Machay and Puka Pukara + Cusco Cathedral + Main Inca Temple Qorikancha (1 Saturday + 1 full weekend). Price: US$480.00 per student. Date: / / Signature

5/6 APPENDIX 1: Volunteering and Service Learning Program Application and Letter of Commitment I,, hereby apply to participate in the Volunteering and Service Learning Program of the Cusco International Center for Studies and Research of San Ignacio de Loyola University (USIL) from to. I undertake to fulfill the tasks assigned to me by the University and the Volunteering and Service Learning Program host organization(s) / institution(s) in a timely and conscientious manner over a total of hours, within the abovementioned time period. Date: / / Signature

APPENDIX 2: Extracurricular excursions: details 6/6 CUSCO AND SURROUNDINGS + SACRED VALLEY + MACHU PICCHU Our program offers students faculty-led excursions to Machu Picchu, as well as the Sacred Valley of the Incas, where the Incas built a series of royal residences set amid the stunning scenery of a green, temperate valley, and sightseeing highlights of Cusco and its surroundings. Students travel accompanied by our specialist faculty staff, using services provided by professional tour companies. Cusco and surroundings - full day Cusco cathedral (entry ticket included) Qorikancha Museum (entry ticket included) Saqsaywaman fortified temple complex (Inca site near Cusco, entry ticket included) Qenqo (Inca site near Cusco, entry ticket included) Puka Pukara (Inca site near Cusco, entry ticket included) Tambo Machay (Inca site near Cusco, entry ticket included) Transport to Inca sites (van or bus) Participation of USIL teaching staff Services of a professional guide Sacred Valley of the Incas + Machu Picchu: 2 days/1 night Pisac: Inca royal estate (entry ticket included) Moray: Inca concentric circular terraces; and Maras salt pans (entry ticket included) Ollantaytambo: Inca royal estate (entry ticket included) One day visit to Machu Picchu (entry ticket included) 3 star hotel in Aguas Calientes (shared rooms) Transport in the Sacred Valley and from the train station to Cusco (van or bus) Train to Aguas Calientes (round trip) Bus Aguas Calientes Machu Picchu (round trip) 2 buffet lunches (Sacred Valley and Aguas Calientes) Participation of USIL teaching staff Services of a professional guide Price: US$ 480.00 per student. 1. All excursions are private 2. MINIMUM: 4 students 3. Group of 4 to 6 students: the professor will join the excursions to Cusco and the surrounding area as well as the Sacred Valley, NOT Machu Picchu; 7 students or more: the professor will join all 3 excursions. 4. ISIC card is required for excursions; the cost of an ISIC card (US$12.00) is not included in price of the packages. Students may use ISIC cards issued in their home country; USIL can help those students who do not have an ISIC card to obtain one at no additional cost to the abovementioned US$12.00. This process usually takes 1-2 days. 5. To allow use of the same visitor s ticket (entrance fee), no more than 1 week should pass between the excursion to Cusco and its surroundings and the excursion to the Sacred Valley of the Incas. 6. Prices quoted are valid for 2017. Please consult with your study abroad provider or the Cusco center directly to inquire about updated prices