Sign in to your Google account to fill out this form
This form contains features which require sign in. Your identity will not be revealed.
San Gemini Preservation Studies Application Form 2018
Please use this form to apply to our programs this summer. Once you submit your form, you should receive an email confirming receipt within 24 hours including instructions on how to complete your application. Contact Polly Withers if you have any questions regarding this form at
or if you do not receive an email acknowledging receipt of your application. Make sure to add
to your safe senders list or our reply may end up in your junk mail unnoticed. SGPS accepts students of varying levels of experience and from a wide range of disciplines. Some of the questions on this application form are to give us an idea of your level of experience and your interests.
Legal Last Name (as it appears on your passport)
Legal First Name
Preferred Nickname (if different from legal first name)
Permanent Home Address: Street and Apartment Number
Use an address where you can receive mail
Home Address: City
Home Address: State
Home Address: Zip Code
Postal Code if not in US
Home Address: Country
Phone (with country and area code)
This is necessary for accommodations
Date of Birth
Necessary for insurance
Place of Birth
Do you have a valid passport?
Country of Residency
What is your Home University?
Present Class Standing: Freshman, Sophomore, Junior, Senior, Graduate or Other (list)
Foreign languages studied (list):
I have studied abroad before:
If yes, please list
I have traveled abroad before:
If yes, please list
I plan to fund my participation in this overseas program by:
Please list, for example through personal funds, parents, financial aid or other means
Degrees and majors you hold:
Please check the subjects below in which you have some experience
Preservation & Restoration
Art & Architectural History
Please check if you have experience in either of the below computer software
Travel abilities: Are you capable and willing to travel alone in Europe if necessary?
If no, please explain.
Do you have any situations or conditions that could become a problem while participating in our program?
If yes, please explain.
How did you hear about our program?
This is helpful information for our recruitment staff
Email received from your professor
Previous SGPS participant
Study Abroad Fair
Received the brochure
Surfing the internet
Are you a member of restoration or culturally related societies? If so, please list.
Interest and Considerations: Please describe briefly why you want to enroll in our courses, how they relate to your academic or professional interest, and any qualifications we should consider while reviewing your application to the San Gemini Preservation Studies 2018 program.
Select the classes to which you wish to apply. You must register for both courses within a program.
Session 1: May 28 to June 22, 2018
Please select both courses in Program A, Program B or Program C
Program A –Touching the Stones – Historic Building Restoration and Analysis Course #201: Introduction to Art and Building Restoration in Italy (equivalent to 3 Units)
Program A – Touching the Stones – Historic Building Restoration and Analysis Course #209: Drawing and Analyzing Historic Buildings (equivalent to 3 Units)
Program B – Ceramics Restoration – Course #203A: Introduction to Conservation of Archaeological Ceramics (equivalent to 3 Units)
Program B – Ceramics Restoration – Course #203B: Archaeological Ceramic Conservation – Workshop (equivalent to 3 Units)
Program C - The Craft of Making and Restoring Book Bindings - Course #204A: Introduction to the History and Craft of Book Bindings (equivalent to 3 Units)
Program C - The Craft of Making and Restoring Book Bindings - Course #204B: Introduction to the Conservation and Restoration of Books (equivalent to 3 Units)
Session 2: July 9 to August 3, 2018
Please select courses in either Program D, Program E or Program F
Program D – Paper Restoration – Course #206A: Introduction to Restoration of Paper in Books and Archives (equivalent to 3 Units)
Program D – Paper Restoration – Course #206B: Introduction to Restoration of Paper in Books and Archives – Workshop (equivalent to 3 Units)
Preservation Theory and Practice in Italy – Course #207 (equivalent to 2 Units) elective course for Paper Restoration participants
Program E – Painting Restoration – Course #208B: Methods and Materials in Traditional Italian Painting and Conservation Issues – Painting Workshop (equivalent to 3 Units)
Preservation Theory and Practice in Italy – Course #207 (equivalent to 2 Units) required course for Painting Restoration participants and elective for Paper Restoration participants
NEW Program F – Carsulae Roman Baths Excavation Survey Project – Course #211 (equivalent to 6 Units) If you are applying to this program you will be contacted for further information.
PreservatiPreservation Theory and Practice in Italy – Course #207 (equivalent to 2 Units) elective course for Carsulae Survey participants
Intersession Field Trips 2018
Intersession Field Trip Italy – Course #205: Siena – Florence – Rome (equivalent to 1 Unit) – June 24 to July 4 2018
Level of Participation
Determine if you are taking the program for a certificate of completion and an evaluation issued by SGPS or for credit by your university. If you are interested in receiving credit for your participation you must contact your home university.
Graduate Level - this level will involve extra work, to be determined by the faculty of the SGPS program.
Audit - you must attend at least 3/4 of the classes in order to receive a certificate of completion.
Yes, I will be applying for credit from my home university
The information I have supplied in this application is true and accurate to the best of my knowledge. If accepted to the program, I agree to and accept the following: 1. I will forward my transcript as per my crediting university’s requirements. 2. I will purchase travel health insurance required by the San Gemini Preservation Studies Program. 3. I authorize the Study Abroad Coordinator to release any information deemed relevant to my health and/or safety.
By ticking this box you are agreeing to the above statements.
Note: The San Gemini Preservation Program may be cancelled if the minimum enrollments are not met. You will be informed of such a cancellation after March 15, 2018. Please do not make travel arrangements until you have been accepted and received confirmation that the program will take place. SGSP reserve the right to review the applicants and determine who will be accepted into the programs.
Refund Policy: On March 15th SGPS established that we have the enrollment required for programs A, B, C, D and E to go ahead. Should the program be cancelled due to any SGSP decision, applicants will be fully refunded. If an applicant withdraws their application before the March 15th deadline, they will be refunded the $450 deposit but not the $50 application fee. At this point, those students that withdraw their application will not receive a refund of either the application fee or the deposit.
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service