APPLICATION FOR PARTICIPATION IN STUDY ABROAD EXCHANGE PROGRAMS

General Instructions: You can use the [tab] key to move forward from field to field and [shift]+[tab] to move back a field. You can also select a field by clicking in it with your mouse. When you see a down pointing arrow next to a field, click on that and hold it down to display the choices. While still depressing the left mouse button, you can move your mouse to the appropriate choice. The item highlighted when you release the mouse button will be selected and will appear in the field. The check boxes at the end will not respond to the tab key; you just need to click each box that applies with your mouse. You do not have to fill out every field; just fill out the fields that apply to you. Required fields are marked with an * in front of them. Click the Send Application button at the end of the form when you have finished filling out the form.

Application:


*Date of Entry: **Example: MM/DD/YYYY
Gender:
*First Name (as it appears in your passport):
Middle Initial:
*Last Name (as it appears in your passport):
*Student ID Number:
Year of Graduation:
Date of Birth:
Country of Citizenship:
*Mailing Address:
*City:
*State:
*Zip:
Home Phone: **Example:123-456-7890
Cell Phone: **Example:123-456-7890
E-Mail address:
Name of Foreign Exchange Partner:

Emergency Contact Information
Emergency Contact First Name:
Emergency Contact Last Name:
Relationship:
E-Mail address:
Day Phone: **Example: 123-456-7890
Evening Phone: **Example: 123-456-7890
Cell Phone: **Example: 123-456-7890
Emergency Contact Address:
City:
State:
Zip:

The name of a Pace Law School faculty member who can comment on your academic work and interest in participating in a foreign exchange program:

I certify that the above information is complete and accurate, and that I will notify Pace Law School of additional information or changes to the information provided in this application.