Study Away Inquiry Form

* = required field

First and Last Name (as they appear on your passport) *

First

Last

Middle Name (as it appears on your passport) *

Suffix, if applicable (as it appears on your passport)

Date of Birth *

YYYY

Current Class Status *

Class Status During Off-Campus Study *

Malone Email Address *

Secondary Email Address

Phone Number *

###

####

Off-Campus Program Location (You may enter multiple locations or "undecided" if you are not sure at this time.) *

Anticipated Semester for Off-Campus Study *

Anticipated Year for Off-Campus Study *

Major *

Minor (if applicable)

GPA (Must a number less than or equal to 4) *

Name of Advisor 1 *

Name of Advisor 2 (if applicable)

Best dates and times to meet with a member of the CCCE

Additional Information

Spam Prevention *

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Malone University - Christ's Kingdom First