1 Start 2 Complete Note: application will not be processed until the $50.00 (U.S.) application fee is sent to the address below. Mailing Address: Coordinator of International Students and Off-Campus Programs Dordt College 498 Fourth Ave NE Sioux Center, Iowa 51250-1606 Phone: 712.722.6273 Fax: 712.722.6035 Email: Rebecca.Tervo@dordt.edu Current Classification * Freshman Sophomore Junior Senior Name * Personal Email Address * College Information Name of College * Address * City * State/Province * Zip/PC * Phone * Personal Information Permanent Address * City * State/Province * Zip/PC * Phone * College Email * Photo of Yourself * Files must be less than 5 MB.Allowed file types: gif jpg jpeg png. Birthdate * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19191920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019 Birthplace * Citizenship * Sex * Male Female Major * Minor Cumulative GPA * Although Dutch language skills are not required for acceptance in SPICE, it is helpful to know if you have any competency in Dutch. Are you able to understand and speak (read/write) Dutch? If so, how did you acquire this knowledge? * Have you had within the last three years any physical, mental, or emotional condition that has interrupted your studies or employment for more than a month or that has required hospitalization or professional care? * Yes No If yes, please explain Have you confirmed that your health insurance policy will adequately cover you while you are in a foreign country? * Yes No Health Insurance Company * Application Essay Questions Thinking about the whole program, why would you like to be a SPICE participant? (200-250 words) * What is the relationship between SPICE and your vocational and personal goals? * Thinking about the courses, which of the tracks would you like to follow? * Western European Culture Nursing TESL Track International Business What are your reasons for choosing this track (100-150 words)? * Please list all courses you intend to take during this program: * Transcript: Please send an official transcript and list of the courses you are taking at the present time. If in digital form, the transcript can be sent to Rebecca.Tervo@dordt.edu. Recommendations: Have two faculty members and one student services member who know you well write letters of recommendation and have them sent directly to the address at the top of this form. Click here for recommendation forms for faculty and student services members to fill out, or request them from Rebecca Tervo at Rebecca.Tervo@dordt.edu. Application Fee Information A $50.00 (U.S.) non-refundable application fee must be sent to the address at the top before this application will be processed. Once an applicant has been accepted to the program, a non-refundable deposit covering the student visa cost to the Netherlands will be required to confirm your place in the program. Statement Of Faith: Dordt College (Sioux Center, Iowa) and the Reformed University (Gereformeerde Hogeschool, in Zwolle, The Netherlands) acknowledge, in harmony with the Reformed confessions, that the Scriptures are the Word of God. As God's infallibly and authoritatively inspired revelation, the Bible makes known the way of salvation in Jesus Christ, requires a life of obedience to the Lord, and provides the key to understanding, interpreting, and finding purpose in life. Both Dordt College and the GH aim to establish in SPICE an environment that is conducive to the academic and spiritual development and welfare of its participants. SPICE seeks as students men and women who are committed to biblical, Christian principles. The faculty and students of SPICE constitute a Christian community in which all must seek to speak the truth in love as brothers and sisters in the Lord. Christ calls upon both faculty and students to encourage one another to lives of faithful obedience to Him. It is expected that students will strive to obey the Lord's teaching in every area of their lives. Students who do not share this Christian commitment may not be in a position to appreciate SPICE's educational and cultural experiences. Students who come to SPICE should be fully prepared to abide by Christian standards and the policies of the program as expressed in the student handbook. I have read the above statement, and as a future member of the SPICE community, I agree to live within the expectations and policies of the program. * Yes No
