You must fill out the form, print, and then submit this form to Mary Beth Coen in the Student Life Office, J.C. Williams Center, and pay a refundable deposit of $170 to the Enrollment Services counter, Lower-level of Starvaggi Hall. You can mail it along with your payment to Miss Coen at: Mary Beth Coen, Student Life Office, J.C. Williams Center, 1235 University Blvd., Steubenville, OH 43952.

 

Student ID#

Name

Current Status in M.A. Theology Program: (Credits earned)

Expected Date of Graduation:

Local Phone:

Local Address:

Summer Phone:

Summer Address:

E-mail address:

Have you ever been abroad before? YES NO

If so, how many times?

Citizenship: Do you have a passport? YES NO

If so, when does it expire?

PLEASE NOTE: The Italian Consulate requires that you MUST have a passport valid for three months beyond your expected date of return. If your passport will expire before this date, you must renew it immediately. New U.S. passport processing may take 6-8 weeks from start to finish. U.S. passport renewal usually takes 2-4 weeks.

Signature: _____________________________________________________ Date:__________________________

For Office Use Only GPA:______________ Credits Earned: _______________ Eligible: YES NO Acc. Letter Sent.:___________________

AFTER COMPLETING THE FORM: PLEASE MAKE SURE YOU PRINT THIS OUT AND TAKE IT TO ENROLLMENT SERVICES (located in Starvaggi Hall) WITH YOUR PAYMENT.

HOWEVER, IF YOU WOULD LIKE TO PAY VIA MC/VISA YOU MAY SUBMIT THE FORM VIA E-MAIL AND PAY BY CLICKING THE SUBMIT BUTTON AND "PAY FOR YOUR DEPOSIT..." BUTTON BELOW.

 

NOTE: Expenses for Fall 2002 were $5,800 which includes tuition for 9 semester credits and lodging,. This does not include air fare, meals, personal travel, souvenirs, and health insurance. If you would like information for Spring 2003, please contact Mary Beth Coen, Director of Study Abroad and International Programs at (740) 283-6513, or e-mail her at mcoen@franciscan.edu.