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Registration for Loyola's Study Program in Belgium 2008

July 9 to August 6

 

PLEASE PRINT CLEARLY:

 

Name:

 

Social Security Number:

 

Date of birth:

 

New Orleans address:

 

 

 

Local telephone number:

Home telephone number:

 

Home address:

 

 

e-mail address:                                                         Do you check your e-mail?

 

Name of individual(s) with whom you would like to room [the rooms accommodate 2 or 3]:

 

 

From which city will you begin this trip?

 

Do you wish to return to the U.S. at a later date? When? ( We must know when you register).

 

 

Which 2 courses do you wish to take:

 

_____HIST Q160: “ World War I in History and Literature” (Common Curriculum)

 

_____HIST G364: “ The History of Belgium”

 

_____HIST Q170 "The American Character" (Common Curriculum)

 

_____RELS O152:  "Catholicism" (Common Curriculum)

 

There are a limited number of places; first come first serve. Cost: $4,300 (or $3,400 without airfare). A non-refundable deposit of $500 is due at registration. A payment of $1,500 is due by Jan. 15, $1,300 is due by March 30, and the balance of $1,000 is due by May 1st . Return form to Dr. David Moore, Dept of History, Bobet 426, Loyola University, New Orleans, LA 70118.  

Updated March 30, 2008