Application for Cross-Cultural Leadership (Padua/Venice, Italy)

Application for “Cross-Cultural Leadership” (Padua/Venice, Italy) Study Tour March 11-20, 2016 (Spring Break)

Please complete the following application to participate in the study tour to Italy. 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. Lori Risley at [email protected] or deliver to HES, 200 by 4:00pm Dec. 1, 2015. If you have any questions, contact her at 405-974- 5533. 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 for transportation – Airplane, Bus, Train, Feet. Do you have any problems or concerns with traveling this way? Is so, please explain.

3. We will be engaged in physical activities, including a great deal of walking, during our time in Italy. In order to keep the pace of our travel, students will be required to walk quickly and to navigate the busy city. Padua and most of our Italian sites will have uneven walkways, steep stairs, etc. Additionally, students are responsible for managing their own luggage and belongings. Do you have any medical or physical issues that would impede your participation in physical activities or efficient walking? Is 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 and travel well with others. 6. Describe your plans for your academic and/or professional future.

______Signature Date