Study Abroad Japan 2022 Pre-application form

Please submit the form below if you are interested in participating in our program. Please note that our program is pending upon the final approval by the administration.

E-mail Address: *

Last Name *

First Name *

Student ID *

Gender *

Male
Female

Home town (City, State, Country) *

Major *

You are: *

Freshman
Sophomore
Junior
Senior
Graduate Student

In the scale of 1 to 5 with 5 being that you have already decided to join the program, what is the degree of your interest at this point? *

1
2
3
4
5

Did you attend Fall Forum on Study Abroad on October 20, 2021 and sign up your name at the Japan Program Table? *

YES
NO

Classes interested *

MA 243
MA 335
MA 412
CHEM 110/113
Some other class

If you answered "some other class" for the previous question, what class would you like to take?

If we offer an elective math class entitled "origamics" that would count towards your degree, will you be interested in taking the class? *

Not interested
Interested
Highly interested

If we offer an elective humanity class entitled "Japanese culture" that would count towards your degree, will you be interested in taking the class? *

Not interested
Interested
Highly interested

Are you interested in repeating a class that you have already taken for a better grade/understanding? *

Yes
No

Have you been to Japan? *

Any comments or questions?

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