Hofstra In La - January 2015 Application - Complete All Three Parts printable pdf download

Hofstra In La - January 2015 Application - Complete All Three Parts

Hofstra in LA

January 2015 Application

Complete All Three Parts

Part I

Name: ___________________________ ID Number:____________________________

Year of Study:_____________________ Major GPA: ___________________________

Major: ___________________________ Minor:________________________________

Name of one or more faculty members who can serve as a reference: ________________

_______________________________________________________________________

E-mail address: _________________________Cell Phone #: ______________________

Campus Address:_________________________________________________________

Permanent Address: ______________________________________________________

Parent Signature (if you are under18 years of age):______________________________

Parent E-mail address:________________________________________________________

Parent Phone:_________________________________________________________________

How did you hear about the program?:_______________________________________

Answer the two following questions on a separate sheet(s) of paper and attach to the application.

1. Indicate the reasons why you want to participate in the “Hofstra in LA” trip.

2. How do you think this program will contribute to your personal, academic, and professional

development?

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Hofstra In La - January 2015 Application - Complete All Three Parts