Oxford Program Application

Middle Initial:

Nickname (if applicable):

Date of Birth:

Place of Birth

City/State/Country

Student ID #:

Current Mailing Address

This address is valid through:

(day/month/year)

Street Address:

Box/Apt. No. (if applicable):

City, State and ZIP Code:

Email Address:

Permanent Mailing Address

Street Address:

Box/Apt. No.:

City, State and ZIP Code:

Phone Number:

Please complete even if the same as above

Email Address:

Please complete even if the same as above

Academic Information

Academic Major:

References

Please list names and department affiliation of TWO St. Bonaventure faculty, staff or administration members who can attest to your academic and personal character. (At least one must be a faculty member.) Please inform both references that they will be contacted by Anne Lee, assistant director of the Francis E. Kelley Oxford Program.

1. Name of Reference:

SBU Department/Office:

2. Name of Reference:

SBU Department/Office:

Please Answer the Following Questions

At Oxford you will be outside your customary American medical care system, so please tell us about any condition, physical or emotional, for which you are being treated or for which you are taking medication.

Enter "none" if this does not apply.

Please list all medications you are currently taking.

Enter "none" if this does not apply.

Do you have dietary restrictions or food allergies about which we should notify the culinary staff at Trinity College? Trinity is very accommodating to dietary requirements but they must know in advance.

Enter "none" if this does not apply.

Authorization & Instructions

BY CHECKING THE BOX BELOW I acknowledge my understanding that Oxford program directors Mike Jones-Kelley and Anne Lee will check my SBU academic and disciplinary records. Further, I understand that participation in the Oxford program is guaranteed to the first 35 accepted students to submit complete application materials along with a $250 deposit* (nonrefundable) and that additional applicants will be wait-listed and accepted according to room availability at Trinity College

*If you are not accepted to the Francis E. Kelley Oxford Program your deposit will be refunded.

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St. Bonaventure University

Trinity College, Oxford | July 1 through Aug. 12, 2022

Final Deadline is March 1, 2023, or when all slots are filled, whichever comes first.

Applicant Personal Information

Current Mailing Address

Permanent Mailing Address

Academic Information

References

Please Answer the Following Questions

Authorization & Instructions