Application for South Africa Summer Study Trip 2013
Write your name exactly as it appears, or will appear, on your passport
Account you check most frequently
Home/cell phone number
Whatever is easiest number by which to reach you.
Date of Birth
Month/Day/Year - needed for airline ticket reservation
I have a valid US passport
Must be valid through November 2013
Yes, I have a US passport valid through Nov 2013
No, I don't have a US passport but I am currently applying
I am a foreign student and my foreign passport has validity through Nov 2013
Class standing as of September 2012
Declared (or expected) major
Name of Advisor (if TUG/DC/Grad student)
If no Advisor, list assigned FPU mentor
Please provide the names of two members of the FPU faculty, staff, or administration who are willing to serve as personal references for you.
Please note any special circumstances that need to be taken into account, such as diet restrictions, allergies, etc. (Put "none" if none.)
Please write a few brief paragraphs in which you explain why you are interested in the South Africa Summer Study Trip. Please mention (1) any previous contacts that you might have had with things related to South Africa; (2) any special interests or reasons that you might have for wanting to participate in the FPU South Africa Summer Study Trip; (3) special interests you have that you want to pursue while you are in South Africa.
Never submit passwords through Google Forms.
Terms of Service