Cascadia College is an equal opportunity institution and does not discriminate on the basis of race, color, religion, gender and/or
sex, disability, national origin, citizenship status, age, sexual orientation, veteran’s status, or genetic information. All Cascadia
materials are available in alternative formats and can be requested by contacting the Human Resources office.
Preliminary Application
Program Site: ___________________________ Quarter: ________________ Year: _______________
Personal Information
Family Name First Name
*Print name as it appears in your passport
Passport # (if you have one) Country of Citizenship
Date of Birth Student number
*Must be age 17 by program start date; the Florence, Italy Program has a minimum age of 18.
E-Mail Address
Telephone #
Current Address
Permanent Address
Education
Dates of Attendance: From To
Field of Study: Cumulative GPA (2.5 or higher)
“I hereby certify that I have successfully completed at least 12 college credits of academic coursework
with a cumulative GPA of 2.5 or higher.”
Signature: Date:
Please continue on next page….
Cascadia College is an equal opportunity institution and does not discriminate on the basis of race, color, religion, gender and/or
sex, disability, national origin, citizenship status, age, sexual orientation, veteran’s status, or genetic information. All Cascadia
materials are available in alternative formats and can be requested by contacting the Human Resources office.
Parent(s)/ Spouse or other Local Emergency Contact
Name(s) Relationship to you
Address
Telephone (work) (Home)
E-mail
Please attach the following to this application:
1. Unofficial copy of most recent college transcript showing completion of at least 12 academic
credits with cumulative GPA of at least 2.5
2. Two letters of recommendation (at least one from a college faculty member); can be submitted
via email. *Letters from family or friends are not acceptable.
3. Essay - On separate paper, please describe the reasons you would like to study abroad, what you
hope to accomplish while studying abroad, and how you hope to incorporate the experience into
academic or career plans. (1 page maximum, 1 ½ spaced)
Please check for reasonable accommodation:
I would like to have reasonable accommodation provided for my disability while I am abroad with
WCCCSA. I would like my campus coordinator to provide me with information about how to request
reasonable accommodation(s).
Please read and sign the following:
“I agree to attend a mandatory advising session with my campus study abroad advisor and will contact
the Study Abroad Office to arrange for an appointment. I also agree to attend the mandatory pre-
departure orientation if I am admitted to this study abroad program. I understand that I am personally
responsible for meeting all required deadlines and payment obligations or I risk being penalized. I
understand that I am applying for a full-time academic college program, and will be expected to
participate in and complete all required coursework including regular classroom attendance and
participation in academic activities. I further certify that I am in good academic standing at my home
institution, and that I am not subject to any action at law or facing any pending legal action that would
preclude me from departing or re-entering the USA. I also understand that I am subject to the WCCCSA
Student Guidelines when I go abroad on a WCCCSA program. Lastly, I understand that if I choose to
have reasonable accommodation(s) for my disability, I must work with my campus coordinator prior to
departure on arrangements. The information I have provided in this application is true and accurate
and subject to verification.”
Signature: Date:
Please return your completed application to:
Cascadia International Programs
international@cascadia.edu
CC1-040 / 425-352-8415