PACIFICA INSTITUTE 2016 Turkey Study Abroad Program Application Form

Name

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Last Name

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Are you a US citizen or a Permanent Resident? *

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Date of Birth

Type of program you are enrolled

If you are a professional please choose so from the below options.

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University or organization

The name of your current university or instution. Professionals and recent graduates should put the name of their current affiliation

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State

The state where your university/organization is located. Professionals and recent graduates should answer for their current affiliation.

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Department/ School

Department or School that you are currently enrolled in such as Department of Government, School of International Studies etc. If you are a professional type the department/section in your organization if applicable.

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Major

Please state your current major or area of study such as Economics, Sociology, Political Science, International Relations etc. If you are a professional put "professional".

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Area of Study/ Concentration

Your current area of study/focus or concentration within the major that you mentioned above. If you are a professional put "professional".

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Your Year

Your current year in this program

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Expected Year of Graduation

If you are a professional please choose "professional".

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Your current GPA

Professionals and Graduates please put N/A

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Previous Degrees Earned

Please list all the academic degrees you earned previously with the associated majors and minors. For example a BA degree in Economics with a minor in political science. Or an MA degree in International Relations.

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Publications

Please list any publications,books or online postings that you may have with the links to access (if applicable)

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Synopsis

Title and 300-400 word synopsis about the topic as it relates to your current research and your field trip research

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Biography

Please use a 300-400 word biography

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Research and Benefits Statement

A 300-500 word statement detailing your current research and potential benefits of this trip for your study and future career

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Trip Date

Choose the date(s) that suit you. You will be notified of the date you were chosen to.

May 30 (departing from US) – June 10 (departing from Istanbul) 2016

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Your Email Address

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Your Email Address

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Telephone Number

A telephone number we can reach you (with the area code please)

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Supporting Documents

Please sign and mail the below statement to Pacifica Institute along with your check.

I understand and agree to the terms, conditions and requirements of this trip.

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