Duquesne University | Office of International Programs

Online Application

All applications require your Academic Advisor's signature. Please print out the Affidavit form and return it to OIP to complete your application.

Semester of Application:

Name:
First	MI	Last


Female Male

Local Phone #:

Cell Phone #:

DORI ID # (9 characters starting with D):


School of Enrollment:

Major:

E-mail Address:

DOB: (12/25/99)
School Address

Street:		Box:


City:	State:	Zip:


Permanent Address

Street:		Box/Apt.#


City	State:	Zip:

Phone Number:

Emergency Contacts

Primary:
Name:
Relationship:
Emergency Phone:
Work Phone:

Second:
Name:
Relationship:
Emergency Phone:
Work Phone:
Academic Information

Minor:
Class Standing Abroad:
Freshman Sophomore Junior Senior
GPA:
Academic Advisor:
Advisor Approval: (Downlaod Affidavit, submit to OIP)
Optional Information (for statistical reporting only)

Etnic Background:
Native American/Alaskan Native
Asian American or Pacific Islander
African-American
Hispanic-American
Caucasian/White, Not-Hispainc
Multicultural
Do Not Know

How did you first hear abouth this study abroad program?
Study Abroad Advisor/OIP
Academic Advisor
Peer/Alumni
Faculty
Website
Campus Publicity
Study Abroad Fair
Other:

Please Note:
Your application is not complete until you submit the Affidavit signed by your advisor. Before submitting your online application, print out the Affidavit form by clicking any of the links above. Submit the signed Affidavit to the Office of International Programs, 601 Union.

Your complete application will hold your place in the Italian Campus program until the $950.00 deposit becomes due (approx. March 1 for fall semester, September 1 for Spring semester). The places of applicants who do not deposit by the published deadlines will be released.

Participation in the Italian Campus program is always contingent upon a minimum cumulative GPA of 2.75 and disciplinary clearance from the Office of Student Life.

(Before submitting this form print out Affidavit Form by clicking the link at the top of this page)

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