Study Abroad

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Name:
Address:

City:State:  
Zip/Country Code: Country:
Phone: Fax:
E-Mail:

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University Currently Attending:
Level: Major:
Expected Date of Graduation:    Month- Year-

I am interested in:   Summer Programs  Semester Programs
Desired Semester to Study Abroad: Desired Year:

I would like to study in the following country/program:

Educational Background/Goals/Other Comments:

How did you hear about us? Please check all that apply.

Internet Search Web listing: URL
Brochure FlyerPersonalized Letter
CIEE Catalog Peterson's Catalog IEE Catalog
Ad: Where?News Article
Radio: Station
Faculty Member Campus Meeting Study Abroad Advisor Past ParticipantWord of Mouth
UM Reputation Other