Short Term Application
Dear applicants! Please submit your documents ONLY in PDF format
Note: * indicates required fields.
*Dates you will be attending (month/date/year):
From
January
February
March
April
May
June
July
August
September
October
November
December
01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
2024 2025 2026 2027 2028
To
January
February
March
April
May
June
July
August
September
October
November
December
01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
2024 2025 2026 2027 2028 2029 2030 2031 2032 2033
*Visa Type:
F-1
J-1
B-1/2
H-1B
Other
If you will be arriving with an F-1 visa, will you be requesting an I-20 from CELAC?
Name as in Passport:
*Family Name
*First Name
Middle Name
Address in Home Country:
*Street Address:
*City
State/Province
Postal Code
Afghanistan Akrotiri Albania Algeria American Samoa (COB) Andorra Angola Anguilla Antarctica (COB,PIC) Antigua and Barbuda Argentina Armenia Aruba (Netherlands) Ashmore and Cartier Islands Australia Austria Azerbaijan Bahamas, The Bahrain Baker Island (COB) Bangladesh Barbados Bassas Da India Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Canal Zone (COB) Canton and Enderbury (COB,PIC) Cape Verde Cayman Islands Central African Republic Central and Southern Line Islands (COB,PIC) Chad Chile China Christmas Island Clipperton Island Cocos (Keeling) Islands Colombia Comoros Congo (Kinshasa) Congo, Republic of The Cook Islands Coral Sea Islands Costa Rica Cote D Ivoire Croatia Cuba Curacao Cyprus Czech Republic Czechoslovakia Democratic Republic of Viet-Nam (COB,PIC) Denmark Dhekelia Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Etorofu, Habomai, Kunashiri, and Shikotan Islands Europa Island Falkland Islands (Islas Malvinas) Faroe Islands Federal Republic of Germany (COB,PIC) Fiji Finland France French Guiana French Polynesia French Southern and Antarctic Lands French Territory of the Afars and Issas (COB,PIC) Gabon Gambia, The Gaza Strip Georgia German Democratic Republic (COB,PIC) Germany Germany, Berlin (COB) Ghana Gibraltar Gilbert and Ellice Islands (COB,PIC) Gilbert Islands (COB,PIC) Glorioso Islands Greece Greenland Grenada Guadeloupe Guam (COB) Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and Mcdonald Islands Honduras Hong Kong Howland Island (COB) Hungary Iceland India Indonesia Iran Iraq Iraq-Saudi Arabia Neutral Zone (COB,PIC) Ireland Isle of Man Israel Israel-Jordan Demilitarized Zone (COB,PIC) Israel-Syria Demilitarized Zone (COB,PIC) Italy Jamaica Jan Mayen Japan Jarvis Island (COB) Jersey Johnston Atoll (COB) Jordan Juan De Nova Island Kazakhstan Kenya Kingman Reef (COB) Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Midway Islands (COB) Moldova Monaco Mongolia Montenegro Montenegro (Prior to 2001) Montserrat Morocco Mozambique Namibia Nauru Navassa Island (COB) Nepal Netherlands Netherlands Antilles (COB) Neutral Zone New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands (COB) Norway Oman Pakistan Palau Palmyra Atoll (COB) Panama Papua New Guinea Paracel Islands Paraguay Peru Philippines Pitcairn Islands Poland Portugal Portuguese Timor (COB,PIC) Puerto Rico (COB) Qatar Republic of Viet-Nam (COB,PIC) Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena, Ascension, and Tristan Da Cunha Saint Kitts and Nevis Saint Martin Saint Pierre and Miquelon Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Serbia (Prior to 2001) Serbia and Montenegro (COB, PIC) Seychelles Sierra Leone Sikkim (COB,PIC) Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and The South Sandwich Islands South Korea South Sudan Southern Rhodesia (COB,PIC) Southern Ryukyu Islands (COB,PIC) Spain Spanish North Africa (COB,PIC) Spanish Sahara (COB,PIC) Spratly Islands Sri Lanka St. Lucia St. Vincent and The Grenadines Stateless Sudan Suriname Svalbard Svalbard and Jan Mayen (COB,PIC) Swan Islands (COB,PIC) Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor - Leste Togo Tokelau Tonga Trinidad and Tobago Tromelin Island Trust Territory of the Pacific Islands (COB,PIC) Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine Union of Soviet Socialist Republics United Arab Emirates United Kingdom United States (COB) United States Misc. Pacific Islands (COB,PIC) Unknown Uruguay USSR Uzbekistan Vanuatu (Nbds,nheb) Vatican City Venezuela Vietnam Virgin Islands (COB) Wake Island (COB) Wallis and Futuna West Bank Western Sahara Yeman (Sanaa) (COB,PIC) Yemen Yemen (Aden) (COB,PIC) Yugoslavia (COB,PIC) Zambia Zimbabwe
*Country
*Date of birth (month/date/year):
January
February
March
April
May
June
July
August
September
October
November
December
01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954
*City of Birth:
*Gender:
Female
Male
*My knowledge of English is:
Low Intermediate
Intermediate
Advanced
*Please, attach a copy of your current passport:
*Please, attach a copy of your financial guarantee/bank statement: