Dean's Office Study Tour Approval Form

Please do not submit this form without complete information. ALL FIELDS are required.

Name:

Email address:

Cell Phone:

Date of Birth (MM/DD/YYYY):

Please indicate your gender

Student ID:

Class year

Major/minor:

GPA:

Are you now or have you been at any time in the past on academic or residence hall probation or suspension?

Yes
No

If you answered 'yes' to the question above, please provide a brief explanation.

Do you have a valid U.S. passport?

Yes
No

If yes, expiration date:

In 150-300 words, please explain why you would like to go on this tour.

Please list the year and semester in which you completed or plan to complete the required pre-requisite (IS251, BH251, CS310 or CS312):

I acknowledge that in order to participate in the study tour, proof of COVID-19 vaccination must be submitted to Student Health Services by Oct. 15, 2021

Dean's Office Study Tour Approval Form

Academic Programs