Application/Registration Form

Registration is on-going now. Please complete this form and submit it along with a $495.00 deposit as well all required documents to the address below. Make check or money order payable to CCRI.
Application/Registration Deadline is February 1st., 2023. Full program payment is due March 31st., 2023. Participants may apply after February 1st., 2023 deadline if space is available.
Please PRINT all information and retain a copy for yourself.

First Name: _____________________________________________
Middle Initial: ___________________________________________
Last Name: _____________________________________________

CCRI ID*:________________________________________________
D.O.B. __________________________________________________

* If you are not a CCRI student, you must fill out a College Registration Form in order to be assigned the CCRI student ID Number. Please e-mail Prof. Mansella [email protected] for further information.

Street Address: ____________________________________________
City: ______________________________________________________
State: _____________ Zip Code: _____________________________

Home Telephone: _________________________________________
Cell.: ___________________________________________________
E-mail: __________________________________________________

Have you studied Italian? _________________________________
If so, when?_______________ Where? _______________________
Highest level courses taken: ______________________________

Institution attended: _____________________________________
Concentration/Major _____________________________________

Special interest: _________________________________________
__________________________________________________________

Why do you want to participate in this program?

________________________________________________________________________________________________

Please indicate your preferences:

___ I am enrolling for credits
___ No Credits/Audit
___ Double occupancy: ___ nonsmoker ____ smoker
___ Single room requested

___ 3 week program (May 16 - June 8, 2023)
___ 2 week program (To be determined according to participants' request and program itinerary)

___ I am an accompanying participant

Course(s) Preference. I am enrolling in:
(Participants may register for a total of 4 credits)

___ Elementary Italian I (ITAL-1030 -3 credits)
___ Conversational Italian I (ITAL -1510 -3 credits)
___ Italian Heritage (ITAL-1900 -3 credits)
___ Italian Culture-Cuisine (ITAL-1910 -1 credit)
___ Italian for Business & Travel (ITAL-1950 -1 credit)

___ Italian Course(s) not listed above

___________________________________________________________

___ Copy of Medical Insurance enclosed
___ Copy of COVID vaccine enclosed (Program's participant must have received all recommended
doses in the primary series COVID-19 vaccine, and a booster dose when eligible)
___ Photocopy of the photo information page of passport enclosed
___ $495.00 Deposit enclosed
___ Release Form enclosed
(The Release Form will be sent to you upon enrolling in the program)

Please read carefully the following information:

The Summer Program in Italy requires extensive long-term planning and preparation.
We encourage participants to enroll as early as possible.
Disclose disability related concerns in a timely manner during the planning process.
Recognize that accommodation planning requires additional time.
Initiate a discussion with Prof. Mansella as soon as possible.
Applications will be reviewed in the order received.
Notification of enrollment in the program will be communicated by the Program Coordinator/Director.

► Final payment is due March 31st., 2023.
►Please make a check payable to CCRI.
► The $495.00 deposit will be applied toward program fee.
► Students enrolled for 3 credits or more must attend the full 3-week program
(May 16 -June 8, 2023)
► Applicants may be interviewed in addition to completing the application.
► Participants must attend pre-departure informational meetings on-line via Zoom and/or in person at the Knight campus, Warwick RI
► Participants will be registered for their courses upon enrolling into the program.
► It is the participant's responsibility to pay his/her tuition directly to the CCRI Bursar's Office before departure.
► The CCRI Program in Italy reserves the right to cancel the program prior to departure for insufficient enrollment or other valid reasons. In the event of cancellation by CCRI, a full program refund will be provided.
► Participants are strongly recommended to purchase travel insurance when booking their flight.
► If a participant must withdraw from the program, a written cancellation letter, must be received in writing in a timely manner.

If a participant cancels, the following policy applies. Charges are calculated as of the day written notification is received:

Sixty days before departure: No refund of administrative study abroad fee $180.
Thirty to 60 days before departure: 25 percent program cost refund, less deposit and administrative fee.
Thirty days or less before departure and after the start of the program in Italy: NO REFUND.

Name (Please print): _____________________________________________________________
Name (Please Sign): _____________________________________________________________

Date: ____________________________________________________________________________

Please mail all required documents with a $495.00 deposit to:

Maria C. Mansella, Professor
Community College of Rhode Island
Department of World Languages and Culture
400 East Ave.
Warwick, RI 02886

World Languages & Cultures

Application/Registration Form

If a participant cancels, the following policy applies. Charges are calculated as of the day written notification is received:

Maria Mansella Links