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Contact Information |
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Student ID Number: |
(919#) |
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Name: |
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Northwest E-mail Address: |
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Local/Campus Address: |
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City: |
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State: |
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Zip Code: |
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Local Phone Number: |
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Home Phone Number: |
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Permanent Address: |
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City: |
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State: |
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Zip Code: |
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Academic Information |
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Current Class Status: |
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Cumulative GPA: |
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Transfer Student? |
Yes
No |
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If yes, from where? |
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Major(s): |
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Emphasis Area |
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Minor(s): |
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Demographic Information |
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Date of Birth: |
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Gender: |
Male
Female |
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Foreign Language Study/Travel Background |
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High School Languages: |
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How many years? |
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College Languages: |
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Number of semesters? |
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Have you traveled internationally? |
Yes
No |
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If yes, explain the following: |
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1. What countries? |
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2. When? |
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3. How long? |
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4. Your purpose:
(i.e. school, vacation, etc.) |
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Study Abroad Information |
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List the countries you would
like to study in:. |
1.
2.
3. |
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When are you interested in studying abroad? |
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What subjects are you interested
in studying while abroad?
(Check all that apply) |
Courses for my major
Courses for my minor
General education requirements
Language courses
Not sure |
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How did you become interested
in study abroad?
(Please specify) |
Friend
Advisor
Study Abroad advertisement
Freshman seminar class
Study Abroad fair
Other |
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