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Student Info Form

Step 1 of 8 - Welcome

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  • Welcome to the Umbra Institute


    Please take 10-15 minutes to fill in all of the necessary information to register at the Umbra Institute. Before starting, make sure you have your passport information, the name of your international health insurance provider and your insurance's policy number.

    Please know that full coverage travel health insurance is required and should include mental health coverage. If you do not believe that you already have proper insurance arrangements, please check with your study abroad office before purchasing a plan independently, as some schools auto-enroll students in a pre-approved plan.

    Filling in this form and signing the waivers is MANDATORY in order to participate at the program.

    You will find the following forms:

    - Personal Info
    - Health Info
    - Behavior Contract
    - Waiver of Liability and Hold Harmless Agreement
    - Housing Waiver
    - GDPR European Privacy Law Agreement

    If you have problems filling in this form please send an email to [email protected]. Thank you.
  • Please provide the best address to which mail or packages could be sent while you are abroad.
    Umbra provides support upon arrival to help you rent a local phone if you prefer to use an Italian cellphone or SIM card. Should you initially choose to have an international plan but change your mind, you can simply supply Umbra staff with your Italian phone number.

    Important: Note that whether you choose an international plan or an Italian number, you are required to have a phone that can send and receive Italian phone calls for the duration of your time abroad. You must keep this phone charged and active. It should not go on airplane mode unless you are in an airplane.
  • Please indicate the email address that you check more often. If it is the same as your school email, please retype it here.
    This is important for emergency communication. Your email will be used only for school-related matters.
  • Please don't use abbreviations. Separate majors with a comma.
  • Please don't use abbreviations. Separate minors with a comma. If you don't have minor type NA.
  • Please don't use abbreviations. Separate concentrations or specializations with a comma. If you don't have any, please type NA.
  • Emergency Contact/Parent/Guardian 1


    It is not required that your emergency contact be a parent or guardian. We simply ask that contact information be provided for someone whom you would like us to reach out to on your behalf, in case of an emergency.
  • Emergency Contact/Parent/Guardian 2


    It is not required that your emergency contact be a parent or guardian. We simply ask that contact information be provided for someone whom you would like us to reach out to on your behalf, in case of an emergency.
  • It is important that you inform us of any and all medical problems (past or current), including mental health conditions, which might affect you during your time abroad. This information could prove vital in assisting you with your health in the event of an emergency. Umbra also uses your health information to accommodate dietary restrictions you may have, when planning events. Please be as specific and accurate as possible. All information provided will be kept in strict confidentiality. I hereby certify that the information below is true and accurate.
  • Date Format: MM slash DD slash YYYY
  • List any health conditions - surgeries, hospitalizations, significant injuries, chronic conditions, physical illness, mental health concern, etc. that may require special consideration or attention while in Perugia, or that may impact treatment should you seek medical assistance while abroad, physically or mentally.
  • Example: vegetarian, vegan, celiac, etc.
  • Documentation for academic accommodations and support is required to ensure individual student needs are met in a timely manner. Please email appropriate document(s) prior to departure for the program or with questions/concerns to: [email protected]
  • Health Insurance

  • About International Health Insurance:
    International health insurance may be acquired independently or through your college/university. If you do not know whether your school provides you with insurance or not, please contact your advisor.

    Should you need to independently purchase international health insurance, we encourage you to compare plans and make sure that you are receiving the required coverage. Most Umbra students typically enroll in GeoBlue, HTH, and/or CISI; all three of which are widely accepted in Italy.

    About the Health Insurance Requirement:
    Italian law requires that all non-Italian students living in Italy, for any period of time, have locally recognized, international medical insurance. If a student needs to go to the hospital, they will be asked for proof of insurance. Any medical treatment a student receives in Italy is subject to a fee, which must be paid up front. Doctors will provide invoices/receipts that students can send to their insurance provider in order to receive reimbursement.
    For these reasons, the Umbra Institute requires that students provide proof of appropriate health insurance prior to their departure. If students arrive without appropriate health insurance, they will be required to pay for all medical services out of pocket, which would be very costly.

    It is very important that students understand their health coverage before leaving for Italy. Plans are very different, with some only covering emergencies and others offering more comprehensive coverage, including physical and mental health support. The Umbra Institute strongly recommends a comprehensive health insurance plan.
  • IMPORTANT: If you know that you will receive insurance through your home institution but you have not received the policy number yet, please type "pending receipt".

    If you know that insurance is not provided through your home institution (common for summer students), please contact your Umbra advisor right away for advice on adequate international health insurance.
  • Most universities enroll their students in an international health insurance plan or provide guidance on a preferred plan. Please check with your study abroad advisor or contact [email protected] for guidance if you have not already enrolled in adequate travel insurance for the full length of your program.
  • Umbra Institute Participation Agreement

    Before signing this contract, please read and make sure you understand the implications of this document and its terms and conditions. By electronically signing this form, you are accepting the terms of the contract and will commit to abide by the following regulations.

    I understand that while studying abroad at the Umbra Institute in Perugia, Italy, I am fully responsible for my conduct according to my home institution’s Code of Student Rights and Responsibilities or particular Code of Honor.

    I recognize that depending on how I represent the Umbra Institute, my conduct can have an effect on the educational benefits both for myself and my peers. I agree that I will conduct myself in a way that will mutually benefit myself, my peers and the Umbra Institute. I also agree to follow all local and national laws, recognizing that such standards might be significantly different from those at my home institution and/or country. I understand that there will be unsupervised free time during which I am responsible for my own safety and conduct.

    Excessive consumption of alcoholic beverages, loud and irreverent behavior toward others, sexual harassment, use of illegal drugs, abusive language, unauthorized absences and/or unwillingness to cooperate with members of the faculty, staff and sponsors are all unacceptable behaviors for myself and others. I understand that any behavior such as those stated above, or that is potentially damaging to the Umbra Institute, Umbra students and/or staff or any other participating party, may lead to program dismissal. I agree that I will receive no refunds for any missed part of the program and I am responsible for any additional fees that may incur due to dismissal.

    Should my conduct during supervised or unsupervised time put myself or my colleagues at risk, I understand that the Director of the Umbra Institute has the right, responsibility, and sole discretion to levy whatever sanctions are deemed appropriate, including immediate dismissal from both the program and housing accommodations.

    Upon notification of my dismissal from the Umbra Institute, I understand that I am no longer enrolled in the program, and therefore am responsible for my own travel arrangements.

    Waiver of Liability and Hold Harmless Agreement

    I hereby affirm that I have voluntarily enrolled in a study abroad program at the Umbra Institute in Perugia, Italy (hereinafter "Institute").

    In consideration of receiving permission to participate in this program, I hereby release, waive, discharge and covenant not to sue the Institute, its officers, agents, servants or employees, (hereinafter referred to as releases) for any loss, damage, or injury, including death, that may be sustained by me, or any property belonging to me, whether caused by the negligence of the releases, or otherwise, while participating in such activity, or while in, on or upon the premises where the activity is being conducted.

    I am fully aware of the risks involved and hazards connected with the said activities: airplane crashes, motor vehicle accidents, political unrest, terrorist incidents, sickness and criminal acts, as well as other risks that may not be foreseeable. If at any time any of the Institute’s programs activities are cancelled or curtailed by circumstances beyond the Institute’s control, or under conditions that, at the sole discretion of the institute, warrant the Institute to call for the cancellation or cessation of activities (academic and non-academic) including reasons caused by an act of God; war; civil commotions; labor trouble; terrorism; governmental interference or directives; US State Department or Center or Disease Control warnings (level 3 or higher); other potential sources of harm beyond the Institute’s control, I understand there will be no refunds. I hereby elect to voluntarily participate in, including but not limited to, all activities, travel and excursions organized by the program, with full knowledge that said activities may be hazardous to my property and myself. I hereby assume any and all such risks. I voluntarily assume full responsibility for any risks of loss, property damage or personal injury, including death, that may be sustained by me, or any loss or damage of property owned by me, as a result of being engaged in any such an activity or related activity, whether caused by negligence of releases of otherwise.

    I further hereby agree to indemnify and hold harmless the releases from any loss, liability, damage or costs, including court costs and attorney fees, that may incur due to my participation in any activities, whether caused by negligence of releases or otherwise.

    I understand that the Umbra Institute does not maintain an insurance policy covering circumstances arising from my participation in any travel, or any activity associated with or facilitating that participation. As such, I am aware that I should review my personal insurance portfolio.

    I agree to grant to the Umbra Institute and its authorized representatives permission to record on photography film and/or video, pictures of my participation. I further agree that any or all the material photographed or recorded may be used, in any form, and further that such use shall be without payment of fees, royalties, special credit or other compensation. I also grant permission to the Umbra Institute to reproduce or alter any portion of the photo images or video that have been taken by me (or by Umbra Institute) that have been submitted to the Umbra Institute, including through the Umbra App and Umbra Social Media and web outlets. I understand I may submit a request in writing to the Institute if I prefer to “opt out” of the photo release and royalty waiver.

    It is my express intent that this waiver of Liability and Hold Harmless Agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a release, waiver, discharge and covenant not to sue the above-named releases. I hereby further agree that this Waiver of Liability and Hold Harmless agreement shall be construed in accordance with the laws of Italy.

    In signing this release, I acknowledge and represent that I have read the foregoing Waiver of Liability and Hold Harmless Agreement, and understand it as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this release for full, adequate and complete consideration fully intending to be bound by the same.

     

  • Student Housing Agreement

    Before signing this contract, please read and make sure you understand the implications of this document and its terms and conditions. By electronically signing this form, you are accepting the terms of the contract and will commit to abide by the following regulations. Be aware that breaching of this contract may lead to eviction with no refund and/or being charged with costs of damage and/or professional cleaning.

    AGREEMENT
    I understand that I must respect the privacy of the other occupants of my apartment and the other condominium residents, and that excessive noise and unacceptable behavior on the premises may lead to eviction. I further understand that the landlord and the Umbra Institute reserve full license to evict a student for inappropriate behavior, as deemed by the Institute, and if a student is evicted there shall be no refund.

    I understand that I am responsible for the condition and cleanliness of the rooms and all other communal areas within the residence, including furniture, equipment and fittings. I am expected to take adequate care of equipment and furnishings and I am responsible for any loss or repairs to items, furnishings and equipment.

    I understand that I must permit the housing agency, its servants, maintenance and cleaning crews to enter the apartment at any reasonable time to inspect and/or carry out cleaning or work for any purpose in the furtherance of their responsibilities or duties. Prior notification may not always be possible.

    I understand that I will not hold the Umbra Institute liable for personal injury of any kind associated with the apartment, residence, home-stay or other housing I have been assigned.

    I understand that I must vacate the premises on or before the date communicated to me by the Institute and that I will leave the premises in the manner in which it was given to me or I may be responsible for cleaning and/or other incurred expenses.

    I understand in leaving the apartment for any reason at any time before the end of the semester that I forfeit all housing monies paid.

    I understand that ANY charges incurred for any reason while living in any of the assigned housing will be distributed equally among all the occupants unless individual(s) that incurred such charges take responsibility.

    I affirm that I have received and read a copy of the Umbra Institute Quality & Safety Policies included in the green orientation folder. This document is also posted in the Umbra buildings in Piazza IV Novembre 23. I will report any equipment failure or dangerous situation immediately to an Umbra staff member.

    My Responsibilities Towards Others Involved

    I understand that I will respect the other occupants of my apartment and other condominium residents and their privacy.

    I understand that I will therefore refrain from excessive noise after 11pm and unacceptable behavior on the premises.

    I understand that for security reasons, and in consideration of others, I may not have overnight guests.

    I understand that I will participate in the division and taking care of tasks including cleaning, tidying up and other necessary tasks to keep the apartment livable for everybody involved. I understand that this may involve adapting my personal habits.

    I understand that I will put in my best effort to live well together with the other students involved and cooperate when any problems/issues amongst us should have to be solved, with or without Umbra’s intervention in the matter.

    I further understand that the landlord and the Institute reserve full license to evict a student for inappropriate behavior, as deemed by the Institute, and if I should be evicted there shall be no refund.

    Utilities & Expenses

    Rent and utility expenses, excluding phone charges, are included in the program fee. Students are expected to respect the privilege of this by carefully monitoring the usage of the utilities. The Umbra Institute has allocated a significantly higher amount for utilities coverage – more than 20% above standard. Excessive use of utilities (electric, gas, heat, water) resulting in bills in excess of the allotted amount will result in additional charges which will be distributed equally among the occupants.

    I understand that I should not use the telephone, even if there is one available, in the apartment. However, if for any reason I do use the telephone, I will be responsible for my portion of the telephone charges during my stay.

    I understand that I will be responsible for my portion of the excess utility expenses including but not limited to electricity, heating, and gas expenses.

    Apartment Cleaning Policy Waiver

    I understand that I am responsible for keeping the apartment clean and tidy as per the landlord’s and Umbra’s minimal cleaning standards. Thorough weekly cleaning of kitchen includes stovetop, counter tops, and floor. Cleaning the bathroom must include keeping the shower drain clear and cleaning shower/tub, sink and toilet.

    Both kitchen and bathrooms must be cleaned WEEKLY and either Umbra staff or landlords can be expected to stop by at any time during the term. If it's determined by the Umbra staff that my roommates and I are not able to maintain the apartment according to the aforementioned Umbra standards, a cleaning service will be employed to do so. In this case, I understand that all occupants of the apartment will be charged an equal portion for this professional cleaning service (200€ per apartment).

    IF YOU HAVE SET UP YOUR OWN HOUSING ARRANGEMENTS, THIS HOUSING AGREEMENT AND CLEANING POLICY WAIVER DOES NOT APPLY TO YOU. (please sign it anyway in order to finish registration)

  • European Union Privacy Compliance (GDPR)

  • Click to read the full GDPR text as it applies to you
    The Umbra Institute follows all privacy regulations relative to EU and US law.

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Piazza IV Novembre 23; Perugia, Italy 06123
Tel: (39) 075-573-4595
Email: [email protected]

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