Outgoing Exchange Students (UNO Students going on exchange overseas)
* Please Select Your Program Aix en Provence Charles University ECES Program Charles University Social Sciences Comenius University Czech Technical University MICEFA Middlesex University Philipps-Universität Rotterdam Conservatory Southern Cross University Universidade Federal of Bahia Universidad Diego Portales Universidad de Costa Rica Universitat Jaume I University of Orleans Universidad de Salamanca
Semester and Year for which you want to participate (check all that apply): Spring 2007 Fall 2007 Spring 2008 Fall 2008
*Last Name: *First Name: Middle Initial: Suffix:
UNO Student ID Number:
U.S. Social Security Number: Passport Number:
Citizenship:
*Mailing Address: *City: *State: *Zip Code: Country:
Major Program of Study : University Classification: University Classification Freshman Sophomore Junior Senior Graduate Birthdate: Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 Gender: Gender Male Female Ethnicity: Ethnicity Other White Non-Hispanic Black Non-Hospanic Hispanic Asian or Pacific Islander American Indian/ Alaskan Nativa Non-Resident Alien Prefer not to respond *Primary Phone: Evening Phone: Cell Phone: *E-mail: Alternate E-mail:
* = a required field
Contact in case of emergency:
Name: Relationship:
Contact's address and/or phone, email, or other contact information:
Academics
Please check one of the following categories: Continuing Student at the University of New Orleans (presently enrolled at UNO) Guest Student (presently enrolled at another university, have applied to UNO as a guest student) Transfer Student (presently enrolled at another university, have applied to UNO as a transfer student)
NOTE: All non-UNO participants must also fill out an online Application for Admission to the University of New Orleans.
Name of institution, if not UNO:
Classification as of August 2006: Freshman Sophomore Junior Senior Graduate Student
Major: Current Cumulative GPA:
Enter your ideas for course selections here if you know them; if you do not, you may wish to consult with Dr. John Hazlett regarding the course offerings available at the host university you have chosen. If you do not know specific courses, at least list the kinds of topics you wish to study while abroad.
Once this application is submitted, please be sure to send or deliver to us all of the required supplementary documents.
Comments Note here any special considerations, questions, etc. Questions needing immediate response should be emailed directly to isep@uno.edu
Click below to send the form:
