Northwest Missouri State University

Inquiry Form

Contact Information
Student ID Number:	(919#)
Name:
Northwest E-mail Address:
Local/Campus Address:
City:
State:
Zip Code:
Local Phone Number:
Home Phone Number:
Permanent Address:
City:
State:
Zip Code:
Academic Information
Current Class Status:
Cumulative GPA:
Transfer Student?	Yes No
If yes, from where?
Major(s):
Emphasis Area
Minor(s):
Demographic Information
Date of Birth:
Gender:	Male Female
Foreign Language Study/Travel Background
High School Languages:
How many years?
College Languages:
Number of semesters?
Have you traveled internationally?	Yes No
If yes, explain the following:
1. What countries?
2. When?
3. How long?
4. Your purpose: (i.e. school, vacation, etc.)
Study Abroad Information
List the countries you would like to study in:.	1. 2. 3.
When are you interested in studying abroad?
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
How did you become interested in study abroad? (Please specify)	Friend Advisor Study Abroad advertisement Freshman seminar class Study Abroad fair Other