HCU Summer Program in Spain

Personal Information

First Name: Required Field

Middle Name

Last Name: Required Field

Date of Birth Required Field

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Address

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City:

State:

Zip:

Contact Information

H Number
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HBU Email

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Travel Information

Do you currently have a valid passport? Required Field

Do you currently have a valid passport? Yes
No

Country of Citizenship Required Field

Education Information

Degree: Major Required Field

Degree: Minor

Classification: Required Field

If, other

Language proficiency in Spanish Required Field

Language proficiency in Spanish Beginner
Intermediate
Advanced

Why do you want to participate in a Study Abroad Experience? Required Field

Why did you choose this program over other programs? Required Field

Interests

I am interested in... Required Field

I am interested in... taking Spanish language courses and culture
doing an Internship in Spanish. (intermediate to advanced language proficiency required)

If you selected INTERNSHIP, what type of internship would you be interested in doing?

If you selected INTERNSHIP, what type of internship would you be interested in doing? Medical / Psychiatric
Business
Bilingual Education

Health Information

Have you been vaccinated against COVID-19? If so, please attach your records below.

Vaccination Record

Please list any illnesses or complaints (including chemical dependency and mental health problems)

Please list any medications taken regularly

Please list any allergies (drug, food, plant, etc.)