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THE STUDIUM URBIS ROME CENTER
2002 SUMMER STUDY WORKSHOP
APPLICATION
The Studium Urbis 2002 Rome Workshop:
"Urban Reciprocity:
Architecture & Urban Planning in Renaissance & Baroque Rome"
June 3 - July 8, 2002 (5 weeks)
Workshop Directors: Allan Ceen (a.ceen@flashnet.it) and Michelle LaFoe (mlafoe@mindspring.com)
http://www.studiumurbis.org
Print this form, complete it, sign it, and send it in the postal-mail to the address listed at the end of this form. Make sure to include the signed and dated "SU Statement of Authorization and Consent Form" and your resume/CV/professional or educational summary. Also keep in mind the length of time required for postal service delivery. If you have not received an email confirmation of its receipt within a reasonable amount of time after having mailed it, please contact us via email. We will respond to all received applications with an email confirmation of receipt (please make sure to list your email address below).
Applications received after February 16, 2002 will be processed on a space-available basis.
Name (Last, First, Middle):______________________________________________________
Birth Date: _____________________________________________
Citizenship: ____________________________________________
Your Mailing Address: __________________________________________________________
City & State: __________________________________________________________
Country: _______________________________________________
Telephone: _____________________________________________
Email address: __________________________________________
Current College/University or Former Alma Mater(s)-Name of Institution(s): ___________________________________________________
______________________________________________________________________
Major(s): ______________________________________________________________
Degree Earned/To be Earned and date(s): __________________________________
______________________________________________________________________ Parent or Guardian Name (if applicable): __________________________________________Parent/Guardian Phone: __________________________________________________
Parent/Guardian Email: __________________________________________________
Parent/Guardian Mailing Address: __________________________________________
_____________________________________________________________________ Reference Contact (Professor, Work or Professional Contacts/Colleagues)Name: ________________________________________________________________
Reference Contact Email: _________________________________________________
Reference Contact Phone: ________________________________________________
List the relevant courses or experience you've had in any of the following: architecture, urban design/planning, history of architecture & urban planning, history of art, Roman/Italian history, general history, cartography, visual studies, classics, and/or Italian: Signature:___________________________________________________________
Date Signed: ________________________________________________________
Submit this form and the other required information to the Studium Urbis Organization's USA contact:
The Studium Urbis Organization
Architecture & Urban Planning Workshop
c/o Michelle LaFoe, Architect & Associate
625 NW Everett, No. 344
Portland, OR 97209 USA
The SU Organization reserves the right to cancel this program; should it do so, refunds will be made in accordance with the refund policy outlined in the workshop description and in the program statement of authorization and consent form.
The Studium Urbis Organization does not discriminate on the basis of race, color, national and ethnic origin, disability, sexual orientation or preference, gender or age in the administration of educational policies, admissions policies, or any other SU program of activity.
updated 12/2001.
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