Application for England & Belgium Study Tour June 1-10, 2012

Revised, 1/23/12 Application for England & Belgium Study Tour – June 1-10, 2012

Please complete the following application to participate in the study tour to England and Belgium. The information you provide will help in the selection of participants and will be held in strict confidence. Send the completed, typed application to Dr. Bryan Duke at [email protected] or deliver to CTL, 214. If you have any questions, contact him at 405-974-5529. Thank you.

Name (as it appears on your passport) ______

If you do not currently have a passport, please check this box. □ You are still eligible to apply.

Date of Birth Passport #

Email(s) ______

Mobile Phone ______Home Phone

UCO ID # * Major ______

Classification (Fresh, Soph, Junior, Senior, Grad) ______GPA ______

1. Have you ever been out of the United States? If so, where, when, and what did you do/see while there?

2. On the trip, we will likely utilize the following vehicles for transportation. Do you have any problems or concerns with traveling this way? If so, please explain.

Airplane Bus

Train Feet

3. We will be engaged in physical activities, including a great deal of walking, during our time in Europe. In order to keep the pace of our travel, students will be required to walk quickly and to navigate the busy city of London. Additionally, London and most of our European sites have uneven walkways, steep stairs, etc. Do you have any medical or physical issues that would impede your participation in physical activities or efficient walking? If so, please explain.

4. What do you hope to learn as a result of your experience on this study tour?

5. As a member of the study tour cohort, what assets, skills, and contributions can you bring to the group travel experience? In other words, describe your ability to work well with and to travel well with others. Revised, 1/23/12

6. Describe your plans for your academic and/or professional future.