Application Form

Last Name       First Name                                      

E-mail address  

Campus Phone:     Best time to call 

What year of college are you right now?  fr so jr sr:

What are your major(s) and minor(s)? 

What is your cumulative gpa, approximately?

Have you been abroad before?  Where and how long?

Where or how did you hear about this program?

Do you realize you can also do a 1 credit ILP in the spring to prepare for this trip?

You are aware of the application deadline of November 30
and $150 deposit deadline of December 5?      

How strongly do you want to do this (from 1-10, ten being strongest desire)?

 Why do you want to participate in this seminar?   

What hesitations might you have about going?   

Other students you would like to recommend for this Berlin program

This form is due December 2, 2002.
$150 deposit due December 5, 2002.
Deposits normally refundable until
January 30, 2003 -- depending on airline regulations