Georgia Institute of Technology

• *First and Middle Names:
• *Last Name:
• *GT Student ID: (Begins with a '9' — Not your SS#)
• *Permanent Mailing Address:
• *City & State:
• *Zip Code:
• *GT E-mail:
• Other E-mail:
• *Phone Number:

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• *How did you hear about the International Plan?

  FASET Brochure in the mail OIE/IP Web site Other:

• *Please Check One

  1st Year 2nd Year 3rd Year 4th Year+

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• *How many hours have you earned?: (including transfer hours, enter numbers only)
• *Expected graduation date: (Format as MM/YYYY)

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• *Major: - Select A Major -Aerospace EngineeringArchitectureBiologyBiochemistryBiomedical EngineeringBuilding ConstructionCivil EngineeringChemical EngineeringChemistryCity PlanningComputer EngineeringComputational MediaComputer ScienceEarth & Atmospheric SciencesEconomicsEconomics & International AffairsEnvironmental EngineeringElectrical EngineeringGlobal Economics & Modern LanguagesHistory Technology & SocietyIndustrial & Systems EngineeringIndustrial DesignInternational AffairsInternational Affairs & Modern LanguagesInternational LogisticsManagementMaterials Science & EngineeringMathematicsMechanical EngineeringNuclear & Radiological EngineeringPhysicsPolymer & Fiber EngineeringPsychologyPublic PolicyScience Technology & CultureTextile EngineeringUndecided Engineering CollegeUndecided Ivan Allen CollegeUndecided Science College

  If Other, please specify:

• If you have a double major, please specify your 2nd major below.

  2nd Major: - Select A Major -Aerospace EngineeringArchitectureBiologyBiochemistryBiomedical EngineeringBuilding ConstructionCivil EngineeringChemical EngineeringChemistryCity PlanningComputer EngineeringComputational MediaComputer ScienceEarth & Atmospheric SciencesEconomicsEconomics & International AffairsEnvironmental EngineeringElectrical EngineeringGlobal Economics & Modern LanguagesHistory Technology & SocietyIndustrial & Systems EngineeringIndustrial DesignInternational AffairsInternational Affairs & Modern LanguagesInternational LogisticsManagementMaterials Science & EngineeringMathematicsMechanical EngineeringNuclear & Radiological EngineeringPhysicsPolymer & Fiber EngineeringPsychologyPublic PolicyScience Technology & CultureTextile EngineeringUndecided Engineering CollegeUndecided Ivan Allen CollegeUndecided Science College

• *Do you speak a language other than English at home/with your family?

  Yes No

  If Yes, which language(s)?:

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Please list the languages you have studied.

Languages studied in High School:

1. Language: Number of Years:
2. Language: Number of Years:
3. Language: Number of Years:

Languages studied in College:

1. Language: Number of Semesters:
2. Language: Number of Semesters:
3. Language: Number of Semesters:

*What language do you intend to use to fulfill the language requirement of the International Plan?

Language:

*Language Requirement

Foreign Language Track or English Language Track?

Foreign Language English Language

• *Citizenship: - Select an Option -U.S. CitizenPermanent Resident/Green Card HolderNonresident Alien/International Student

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• *Gender: Female Male

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• *Racial/Ethnic Group: - Choose an Option -American Indian/Alaska Native Black/African American Native Hawaiian/Pacific Islander Asian Hispanic/Latino White

*Have you lived, traveled, worked, or studied abroad before?

Yes No

If No, skip to next section. If yes, please provide the following information pertaining to your past experiences abroad.

1. Purpose: - Choose an Option -Study Travel/Vacation Parent's Work Internship Grew Up Abroad Country/Region: - Choose an Option -AustraliaBahamasBermudaCanadaChinaEnglandFranceGermanyIndiaJapanMexicoNew ZealandSouth KoreaSpainOther AfricaOther AsiaOther CarribbeanOther Central AmericaOther Eastern EuropeOther OceaniaOther South AmericaOther Wesern Europe
2. Purpose: - Choose an Option -Study Travel/Vacation Parent's Work Internship Grew Up Abroad Country/Region: - Choose an Option -AustraliaBahamasBermudaCanadaChinaEnglandFranceGermanyIndiaJapanMexicoNew ZealandSouth KoreaSpainOther AfricaOther AsiaOther CarribbeanOther Central AmericaOther Eastern EuropeOther OceaniaOther South AmericaOther Wesern Europe
3. Purpose: - Choose an Option -Study Travel/Vacation Parent's Work Internship Grew Up Abroad Country/Region: - Choose an Option -AustraliaBahamasBermudaCanadaChinaEnglandFranceGermanyIndiaJapanMexicoNew ZealandSouth KoreaSpainOther AfricaOther AsiaOther CarribbeanOther Central AmericaOther Eastern EuropeOther OceaniaOther South AmericaOther Wesern Europe

How Long (total for all experiences)?

Less Than 2 Weeks 3-7 Weeks 2-6 Months

7-11 Months 1 Year 2 Years More Than 2 Years

*International Requirement

Use the space below to provide how you plan to complete the 26 week international experience. If you have already completed one or both terms, please provide the dates and general program description.