Conexiones Summer 2011 Spain Application Form

GENERAL INFORMATION

Applicant’s Name ______Banner ID. # ______


Permanent Address ______City ______State _____Zip ______


School Address______City ______State _____Zip ______


Home Phone Number ______Campus Phone Number ______Cell ______


Email address ______


Date of Birth ______

EDUCATIONAL DATA

Major (s) ______Minor (s) ______


Name of undergraduate institution that student currently attends ______

Are you a student in the University Honors Program ? Yes..... No ......

If not, would you like to apply? Yes...... No

Cumulative GPA ______for Semesters (...... )


Class Standing (circle one):

Sophmore...... Junior...... Senior

NON-UNM STUDENTS that need UNM registration forms, please circle one of the following:

Degree status...... Non-degree status


Knowledge of Spanish (circle one):


Beginner ...... Intermediate...... Advanced


Spanish courses taken

______

ATTACH TO THE APPLICATION:

1-  A letter from faculty or a community member who can speak to your readiness for such an in-depth experience. Ask your reference to write the letter and return it to you in a sealed envelope with his/her signature across the back. (Please provide the envelope.) This letter should come from an individual able to speak to your ability to function in a variety of social and living situations. Attach the envelope to your application.

2-  A typed one page, single-spaced statement addressing the question: How do you hope to benefit from your participation in the Conexiones Program in Spain? Attach this statement to your application.

EARLY APPLICATION DEADLINE: February 11, 5:00 P.M.

REGULAR APPLICATION DEADLINE: March 4, 5:00 P.M.

TO TURN IN THE APPLICATION

-  By mail, to: Dr. Celia López-Chávez

MSC06 3890, University Honors Program, Albuquerque, NM 87131-0001

-  OR, drop the application in an envelope at Dr. Celia López-Chávez mail box, Honors Office

(Lower Level of Student Health Services)

IMPORTANT

Within a week after students are notified about being accepted in the program, they must send a $300 non-refundable check to: The University Honors Program.

Conexiones Program fees have been calculated on the basis of a fluctuating exchange rate. In the case of a dramatic drop in the value of the dollar, it may be necessary prior to departure to charge each student an additional $100 for the cost of one excursion.