STUDENT VISA CHECKLIST - SU Abroad

INSTRUCTIONS TO COMPLETING VISA APPLICATIONIF A QUESTION IS NOT APPLICABLE TO YOU, WRITE “N/A”DUE TO THE DIFFERENT DATE FORMAT USED IN SPAIN,WRITE DATES AS DAY/MONTH/YEAR1. Surname = Fill in your last name as shown in your passport2. Surname(s) at birth = Previous last names you may have had, could apply if you are married,adopted, etc. Only if your last name at birth is different than now3. First names = First and middle names4. Date of birth = Day/Month/Year5. Place of birth = City and State where you were born6. Country of birth = Country where you were born7. Current nationality/ies = Your current country of citizenship (this is not your race). If you havemore than one citizenship, list first the one corresponding to the passport that you arepresenting for your application, and then add any other citizenship you may have.Original nationality (nationality at birth) = Your citizenship when you were born8. Sex = Check the applicable: Male/Female9. Marital status = Check your current marital status even if it is different from that what appears inyour passport: single/married/separate/divorced/widow(er)/other10. LEAVE BLANK11. National Identity Number = Social Security Number (US Citizens) or other National ID (non-US Citizens)12. Type of travel document = Ordinary Passport13. Number of travel document = Passport Number14. Date of Issue = Date of passport issue (in passport) Day/Month/Year15. Valid until = Day/Month/Year of expiration (This information is in your passport. It mayappear as “Valid Until” or as “Expiration Date”)*Your passport MUST be valid until at least December 2013!16. Issued by = Place where your passport was issued (located in lower right of US passport.)Usually distributed by United States Department of State or regional passport authority.17. Applicant’s Home Address and email address = Your permanent address and email addressTelephone Number(s) = Home AND cell phone number

18. Residence in a country other than the country of current nationality = If you are a US citizen,but your permanent address is in another country, OR if you are a non-US citizen and yourpermanent address is in a country different from your national passport (ex: non-US citizenliving in the US with a Greencard).19. Current Occupation = Student (even if you work while in school)20. Main purpose of the journey = Study21. Intended date of arrival in SpainEurovision = 11 January 2013Mare Nostrum = 12 January 2013Azahar = 13 January 2013Imperium = 13 January 201322. Number of Entries requested = Multiple Entries23. Applicant’s Address in Spain = Calle Miguel Angel 8, 28010 Madrid, Spain24. LEAVE ALL BOXES BLANK25. LEAVE ALL BOXES BLANK26. Data of the educational establishment or research centre in case of applying for a student orResearch visaName of educational establishment = Instituto InternacionalAddress of the educational establishment = Calle Miguel Angel 8, 28010 Madrid SpainTelephone of the educational establishment = 34. 91. 319. 9942Email address of the educational establishment = drkuehl@syr.eduIntended start date of studies = Eurovision: 11 January 2013Mare Nostrum: 12 January 2013Azahar: 13 January 2013Imperium: 13 January 2013Intended date of end of studies = ALL OPTION I STUDENTS = 15 May 2013ALL OPTION II STUDENTS = 19 May 2013LEAVE ALL OTHER BOXES BLANK27. Place and Date = Where (the city) and when (the date) you completed this form. The locationMUST correspond to the Consulate’s jurisdiction. Since you are applying through theSpanish Consulate in San Francisco, the place must be within AK, Northern CA, HI, ID, MT,NV, OR, WA or WY28. Signature (DO NOT FORGET!)

Application for a National VisaPHOTOThis application form is free1. Surname (Family name) (x) PARTE RESERVADA A LAADMINISTRACIÓN2. Surname at birth (Former family name(s)) (x)Fecha de la solicitud:3. First name(s) (Given name(s)) (x)Número de la solicitud devisado:4. Date of birth (day-month-year) 5. Place of birth7.Current nationalityExpediente gestionado por:8. Sex□ Male □ Female6. Country of birth9. Marital statusNationality at birth, if different:□ Single □ Married □ Separated □ Divorced □ Widow(er)□ Other (please specify)10. In the case of minors: Surname, first name, address (if different from applicant's) and nationality of parentalauthority/legal guardianDocumentos presentados:□ Documento de viaje□ Autorización gubernativa□ Solicitud de autorizacióngubernativa□ Medios de subsistencia□ Prueba de alojamiento□ Certificado médico□ Certificado de antecedentespenales□ Seguro médico de viaje□ Nota Verbal□ Otros:11. National identity number, where applicable12. Type of travel document□ Ordinary passport □ Diplomatic passport □ Service passport □ Official passport □ Special passport□ Other travel document (please specify)13. Number of travel document 14. Date of issue 15. Valid until 16. Issued by17. Applicant's home address and e-mail address Telephone number(s)Decisión sobre el visado:□ Denegado□ Expedido:Válido desde …………hasta ………………….Número de entradas:□ Una □ dos □ múltiplesNúmero de días:18. Residence in a country other than the country of current nationality□ No□ Yes. Residence permit or equivalent ………………… No. …………………….. Valid until* 19. Current occupation(x) Fields 1-3 shall be filled in in accordance with the data in the travel document.1

20. Main purpose of the journey:□ Residence without work permit□ Residence – Family reunion□ Residence – Employee□ Residence – Self-employed□ Residence – Temporary work (9 months in 1 year)□ Studies□ Research (within the framework of an agreement signed by a research centre)□ Accreditation21. Intended date of arrival in Spain 22. Number of entries requested: □ Single entry □ Two entries □ Multiple entries23. Applicant’s address in Spain24. Data of the individual resident in Spain in case of applying for a residence visa for family reunionSurname (Family name) and first name(s) (Given name(s)) of the resident individual in SpainFamily relationship (of the applicant with the individual resident in Spain)□ Spouse□ Registered partner□ Child (of the individual resident or the spouse)□ dependent direct relative in the ascending line of the individual residentor the spouse or partner□ dependent person when the individual resident holds the parentalauthority/is the legal guardianDate of birth Nationality Spanish Alien’s Identity Number (NIE) or number of the SpanishNational Identity Card (DNI)Individual resident’s address in SpainIndividual resident’s telephoneIndividual resident’s e-mail address25. Data of the employer or the company in case of applying for a residence visa for employees, self-employed or temporary workSurname (Family name) and first name(s) (Given name(s)) of the employer or name of the company and surname (Family name) and first name(s) (Givenname(s)) of the contact person in the companyEmployer or company’s addressEmployer or company’s telephoneEmployer or company’s e-mail addressSpanish Alien’s Identity Number (NIE) or number of the Spanish National Identity Card (DNI) of the employer or of the contact person in the companyCompany’s Spanish Tax Identification Code (CIF)2

26. Data of the educational establishment or research centre in case of applying for a student or research visaName of the educational establishment or research centreAddress of the educational establishment or research centreTelephone of the educational establishment or research centreE-mail address of the educational establishment or research centreIntended date of start of studies or researchIntended date of end of studies or researchIn case of temporary stay of children with the purpose of studying in Spain within the framework of a program of a Public Administration, a non-profitorganisation or a charity or other establishment or persons who do not hold their parental authorities/are not their legal guardians:Surname (Family name) and first name(s) (Given name(s)) of the person responsible or name of the organisation and surname (Family name) and firstname(s) (Given name(s)) of the contact person in the organisationAddress of the person responsible or organisationTelephone of the person responsible or organisationE-mail address of the person responsible or organisationSpanish Alien’s Identity Number (NIE) or number of the Spanish National Identity Card (DNI) of the person responsible or of the contact person in theorganisationI am aware of and consent to the following: the collection of the data required by this applicationform and the taking of my photograph are mandatory for the examination of the visa application.Any personal data concerning me which appear on the visa application form, as well as myphotograph, will be supplied to the relevant authorities and processed by those authorities, for thepurposes of a decision on my visa application. Such data as well as data concerning the decisiontaken on my application will be entered into, and stored in a database. The controller is the ConsularPost at which the visa was applied for. Data shall be accessible to the visa authorities and theauthorities competent for carrying out checks on visas at external borders and in Spain, immigrationand asylum authorities for the purposes of verifying whether the conditions for the legal entry into,stay and residence on the territory of Spain are fulfilled, of identifying persons who do not or who nolonger fulfil these conditions, of examining an asylum application and of determining responsibilityfor such examination.I am aware that I have the rights of access, correction and deletion of personal data relating to meand the right to object to the processing thereof, pursuant to the provisions contained in the LeyOrgánica 15/1999, de 13 de diciembre, de Protección de Datos de Carácter Personal, by addressinga request to the Dirección General de Asuntos y Asistencia Consulares of the Ministry of ForeignAffairs and Coopeartion; calle Ruiz de Alarcón 5, 20871 – Madrid (Spain).3

I declare that to the best of my knowledge all particulars supplied by me are correct and complete. Iam aware that any false statements shall lead to my application being rejected or to the annulment ofa visa already granted.I am aware that once the visa request has been submitted, a copy of the form, sealed with theindication of the date and place of reception, shall be returned to the applicant and that arrangementscan be made with the applicant as to the channel to request corrections or the supply of documents orcertificates, as well as to serve notice of summons and to notify the decision adopted in due course.Notices and requests shall be served by telephone or fax to the contact number provided by theinterested party or his/her legal representative. If they were to prove ineffective, they shall be servedin writing to the domicile set out in the application, which must be located within the consulardistrict.Summons and requests served must be complied with within a period not exceeding ten days, unlesspersonal attendance is required in which case the deadline is fifteen days.Once all the possibilities of serving a notice have been exhausted, the notice shall be served bymeans of an announcement posted at the relevant notice board of the Embassy or Consulate duringten days.If no reply is received to a request or summons, the applicant shall be deemed to have withdrawn hisrequest and the resolution establishing this to be the case shall be notified to him.Decisions on a visa application shall be notified within one month of the date of the lodging of anapplication, except for residence visas without work permit. In this case, decisions shall be notifiedwithin three months, but the request for the residence authorisation that has to be issued by thecompetent Delegación or Subdelegación del Gobierno shall interrupt the computation of this periodof time until this authorisation is notified to the Embassy or Consulate.The visa once granted must be collected within a month, unless it is a visa for family reunion or avisa for study purposes; in these cases, it must be collected before two months elapse. If a visa is notcollected within the aforesaid period, the applicant shall be deemed to have renounced to the visagranted and the proceedings shall be filed.I am aware that the visa fee is not refunded if the visa is refused.27. Place and date 28. Signature (for minors, signature of parental authority/legal guardian)4