Application
Form for
(last modified 31 Oct 2007)
Name:________________________________ Date of birth:_________________
Social Security Number:__________________ Citizenship:__________________
Local Mailing Address: Home Address (if different):
_______________________________ ___________________________________
_______________________________ ___________________________________
_______________________________ ___________________________________
E-mail address:_________________________________
Local Telephone Numbers:__________________ _________________ ___________
home work mobile
Major/Minor field of study:_____________________ / ______________________
Expected graduation date:______________ GPA:__________
Academic standing (circle one): Frosh Soph Junior Senior Grad
List any scholarships and honors that you have received:
List any extracurricular activities that you have been involved in over the past two years, i.e., student organizations, jobs, volunteer work, etc.:
Describe any international travel experiences you have had, including country, purpose of travel, length of stay, etc.
Do you intend to enroll in the three credit regular China Studies course, which is cross listed as an undergraduate (IBUS382) and MBA course (GMBA791), in Sp08? Yes No
Do you intend to enroll in the one credit China Study Tour course (IBUS 299) in Sp08? Yes No
Have you taken a Gannon Chinese Language and Culture course? Yes No
If yes: One course Two or more courses List the semesters.
Do you intend to take a Gannon Chinese Language and Culture course in Sp08? Yes No
On separate paper, include a 250 word essay explaining why you would like to participate in the China Study Tour.
Is it understood that receipt of the grant involves assisting the tour leader with administrative tasks, such as preparing and distributing promotional material, contacting participants, etc., this year or next? Yes No
Is it also understood that upon return to
Deadline: All applications must be received on or before 20 Nov 2007. Tour deposit must be received prior to or included with submission of grant application.
Notification: Grant recipients are to be informed by 30 Nov 2007.
Grants received are not to be deducted from amounts due
Completed applications should be submitted to:
Gary Mahan, Ph.D.,
Or left off at PC 2212
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For office use:
Date application received: ______________ Application no.____________
Date deposit received:________________