Summer Short Term Study Abroad Application

Personal Information

First name *

Last name *

FPU student ID *

Birthdate *

Month

Day

Year

Address while at school *

Home address *

Email address *

Cell phone/local number *

Do you have any health concerns that the trip organizers should be aware of (special medications, mental health, travel issues, etc.)? *

Yes

If yes, please describe (this information will be kept confidential)

School Information

Present class standing *

Freshman

Sophomore

Junior

Senior

Planned or declared major *

Minor or second major

Travel Information

During Summer 19 I am interested in going to *

Australia with Rebecca McMillen

Guatemala with Cindy Jurado

Israel with Brian Schultz

Israel/Palestine with Bret Kincaid

I have a valid passport *

Yes

Full name as printed (or will be printed) on passport *

Write a statement which clearly explains why you are interested in going on this FPU study abroad program *

Additional comments or questions

Have two faculty or staff persons use this form to evaluate your potential for a study abroad program. Alternatively, print out this evaluation form and give it to two faculty or staff to complete.

Leave this field blank

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Utilities

Summer Short Term Study Abroad Application

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Study Abroad

Programs & Majors

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Summer Short Term Study Abroad Application

Programs & Majors

Study Abroad

Programs & Majors