St. Bonaventure University

Summer Study in Japan Application


PERSONAL INFORMATION

City/State/Country
Gender

     

CURRENT MAILING ADDRESS

(day/month/year)
   

PERMANENT MAILING ADDRESS

  

CONTACT INFORMATION

Include area code
  

ACADEMIC INFORMATION

Current Academic Status



Are you a HEOP student?

Are you an Honors student?

  

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 Dr. Phillip Payne or Christopher Dalton of the SBU Department of History, coordinators of the Summer Study in Japan program.
  

PLEASE ANSWER THE FOLLOWING QUESTIONS

Enter "none" if this does not apply.
Enter "none" if this does not apply.
Please list restrictions/allergies or enter "none."
  

AUTHORIZATION & INSTRUCTIONS

I ACKNOWLEDGE that Dr. Phillip Payne and Christopher Dalton have my permission to verify my SBU academic and disciplinary records, including a full review of my transcript, and that this application will not be complete until I have submitted a $250, non-refundable deposit.* (Deposits may be made electronically on my.sbu.edu or by taking a check payable to St. Bonaventure University to the Business Office in Hopkins Hall.)
*If you are not accepted to the Summer Study in Japan program your deposit will be refunded.