Application Form Summer Term 2012 Rome-Florence-Munich
July 19- August 7, 2012
Two spots left! -- Take five minutes and apply now!
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Last Name, First Name, (Nickname), Number of College Credits Completed counting Fall Term 2011 [like this: Mitchell, James, (Jake) 64]
E-mail address
Campus Dorm and Room Number
Your Date of Birth
How old will you be in May 2012?
Your cell phone number and best times to call
What are your major(s) and minor(s)?
What activities, sports, and/or social service are you involved in? Give dates and short description of each
What is your cumulative gpa, approximately?
Intended date of graduation (month, year)
Have you been abroad before? Where and how long?
Where or how did you hear about this program?
What is the name of your Faculty Resident?
How strongly do you want to do this (from 1-10, ten being strongest desire)?
Why do you want to participate in this seminar? (about 50-100 words, please):
Describe your personal qualifications for this program and what you would be able to contribute to the group (about 50-100 words, please):
What hesitations might you have about going?
Other students you would like to recommend for this program and their email address if you have it handy:
This form is due as soon as possible so that we can get good arrangements on the airline and in hotels. If there are many applicants, you may be asked to provide a couple letters of recommendation Applicants will be told whether they are part of the program soon after applying.
Applications due ASAP. __ Applications due as soon as possible. It is to your advantage in the selection process if you apply early! __ Deposit of $300 due after you are accepted. You have nothing to lose!
Make sure your application is complete before clicking submit. Thank you. Be ready for the experience of a lifetime!
Fr. Mark's e-mail
Picture Yourself ... | Itinerary |Tour Leader | Application Form | Academic Information | Payment Schedule | Students Comments