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Study Abroad

Name
Email
Telephone
Address 1
Address 2
City
State
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ZIP
  
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Please select you class standing status


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Please select your major





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What is your overall GPA?
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Do you have a current passport?
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Have you traveled internationally before?
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Do you have health insurance?

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Please describe any medical issues or mobility issues we should be aware of. This includes food and medicine allergies.
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Date of Birth
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Please list TWO emergency contacts. Name and best number to be reached
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Will you have sufficient funds for personal expenses and any anticipated independent travel?


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Please describe your plans to pay for the trip?
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Have you ever been convicted of a crime?

If yes, please describe. Include nature of offense, date, and if you are still on probation
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Please select that you agree to the following




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Signature