| Application for The Department of Geography and Geology Study Abroad
Program ONLY TYPED/CLEARLY PRINTED APPLICATIONS WILL BE CONSIDERED |
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____ EASTERN MEDITERRANEAN (May 12, 2008 - June 6, 2008) (Approx $4,300 all inclusive). |
| Last Name: | First Name: | Middle Name or Initial: | |
| Present Mailing Address: | |||
| Present Phone Number: | E-mail Address: | ||
| Permanent Mailing Address: | |||
| Permanent Phone Number: | |||
| Date of Birth: | Citizenship: | ||
| ____Male ____Female | WKU Student ID Number: | ||
| Present College or University: | |||
| Present Class: ____ FR ____ SO ____ JR ____ SR ____ GR ____ Community/Other | |||
| Major/Minor: | |||
| Cumulative Grade Point Average on 4.0 Scale:______ Please request an unofficial transcript from all non-WKU colleges and universities attended. Transcripts must be mailed directly to the Department Head, Department of Geography and Geology, Western Kentucky University, Bowling Green, KY 42101-3576. | |||
| Emergency Contact Name: | |||
| Address: | |||
| Telephone: | |||
| I am applying as a(n): ____ Undergraduate ____ Graduate ____ Community/Continuing Education | |||
| Please list the courses you are interested in taking in order of your preference. (This list is not final; official registration will take place in April 2008.) | 1. | ||
| 2. | |||
| 3. | |||
| 4. | |||
| If accepted for participation into the program, do you wish to travel
on the group flight/itinerary or make your own flight arrangements? ____ Group ____ Independent (Note: The choice you make on this application will be binding upon acceptance. If you choose to make your own arrangements, please call the Department of Geography and Geology office for the amount of flight credit allowed.) |
| Special requests regarding accommodations [roommates; smoking; special diet (vegetarian, etc.); morning/night person, etc.] |
| Are you a smoker? ____ Yes ____ No |
| Medical information: (Please list any medical conditions and
explain in detail, using a separate sheet if necessary. Failure to disclose any and all medical conditions may result in removal from the program.
Doctor's letter releasing you to participate may be requested.)
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| Name of person writing letter of recommendation: |
| From whom did you learn of this program? |
| We would encourage you to discuss the particulars of this program with your emergency contact. May we send duplicate materials relating to this program to your emergency contact if you are accepted? ____Yes ____ No |
| Please write a short essay indicating why you would like to participate in the
Department of Geography and Geology's Study Abroad Program (you can attach a separate page).
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| Note: Failure to provide requested information will cause this application not to be considered. |
I have correctly completed all information. _______________________________________________ Applicant's Signature _______________________________________________ Signature, Academic advisor. |
| Please return this form with a $1,000 check for the program deposit made payable to "Department of Geography Study Abroad Program" no later than January 31, 2008, to: Debbie Kreitzer, Program Director NOTE: A second payment of $1,000 is due no later than February 15, 2008, in order to advance purchase airline tickets. Deposits are non-refundable once airline tickets are purchased and payments made for rail and hotel reservations. A third deposit of $1,000 is due on March 15, 2008, and the final payment of $1,300 is due no later than April 30, 2008. Please submit your payment to: Study Abroad Program Department of Geography and Geology Western Kentucky University Bowling Green, KY 42101-1066 Tel: 270-745-4555 Fax: 270-745-6410 email: debbie.kreitzer@wku.edu Return to Study Abroad homepage. |