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Stritch Semester/Year Education Abroad Program Application Packet Application must be submitted for Spring Semester Abroad by Aug 1 and for Fall Semester Abroad by Feb 1. Please Print All Information Clearly ! Program Location Foreign University Name_________________________________________ Country__________________________ If you are unsure please provide your country preferences________________________________________________ I would like to study abroad during: Fall Year: Spring Year: Personal Information Your Full Name ___________________________________________ Male _____ Female _____ Student ID# ________________ (exactly as it appears or will appear on your passport) Current Address ________________________________________ City __________________ State _______ Zip _____________ Permanent Address ________________________________________ City __________________ State _______ Zip __________ Your Current Phone ____________________ Cell Phone ____________________ Break/Summer Phone ____________________ Stritch E-mail _________________________________________ Alternate E-mail ______________________________________ Date of Birth ________________________ Citizenship ______________________________ SS# __________________________ Date (mm/dd/yy) Do you have a passport? Yes No Passport Number ____________________ Expiration Date ____________________ Date (mm/dd/yy) Academic Information Academic Year Freshman Sophomore Junior Senior Current GPA _________ Grad Date_____________ Date (mm/yy) Major(s) _____________________________________________ Minor(s) ___________________________________________ Your Major/Faculty Advisor ________________________ Phone ____________________ E-mail __________________________ Your One-Stop Counselor __________________________ Phone ____________________ E-mail _________________________ Stritch Application Packet Items to Submit: Program Application International Medical History Disclosure Two Stritch Faculty or Staff References University Release and Waiver Form. Education Abroad Essay and Re-Entry Project (by e-mail) Personal Academic and Work Experience Resume (by e-mail) Foreign Course Approval Form One Passport Size Picture and One Copy of your Passport Picture Page Stritch applications are rolling and you may submit items of your application packet as you complete them. Your Stritch application packet is completed when all items have been submitted. Your Stritch application packet must be complete prior to applying to a foreign university, a CEA program, or an external study abroad related scholarship.

Stritch Education Abroad Application Packet 2012-13

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