C.I.C.E. Study AbroadPayment Form Log in to save time on this form! Personal Information Student First Name Student Last Name Student Id Address City State Zip Program Information Program Term Required January Term Academic Year Calendar Year Fall Semester Spring Semester Summer Term Program Name Program Provider Name Program Year Payment Information Application Fee $70.00 Career Exploration/Internship application fee $35.00 Program Commitment Deposit See deposit due email for program commitment deposit amount. $200.00 $250.00 $300.00 $350.00 $400.00 $500.00 $600.00 $1,000.00 J-Term Payment Application Fee $70.00 January Interim single student Career Exploration/Internship application fee $35.00 Deposit $500.00 Secondary Commitment Deposit $1,000.00 Summer Payment Application Fee $70.00 Summer Study Away Program Fee $150.00 Please select a program term above. How will you be paying the remaining J-Term balance? Payment to the Business office in October. Pay the remaining course amount by a loan. Off-Campus Program Commitment Form You must check the box Off-Campus Program Commitment Form to confirm your participation in your off-campus program with the CICE. You will not be considered a 'confirmed' participant without this form on file in the CICE office. This form is separate from and in addition to any Program Confirmation or Intent to Enroll forms that may also be required by the program providers. You must still confirm with your program provider. I understand by paying this deposit and checking the box above, I am committing to participating in the above noted program. By confirming my participation, I understand that I am now financially liable for any costs incurred on my behalf. I understand that should I withdraw after this time, that my deposit is non-refundable, and that I will be responsible for non-recoverable costs. I understand that Gustavus Adolphus and each Program Provider have payment, cancellation and refund policies by which I must now abide. I understand that my request to withdraw from a program must be submitted in writing to the Study Abroad Advisor. Deposits for all study abroad programs WILL be credited towards your total program fee. Additional Information Notes Submit You will be charged .