Study Abroad Intake Form

Going on Study Abroad?


	Greetings! Please make sure to complete this form prior to your first study abroad advising appointment. The information you share here will help the Study Abroad Advisor understand how they can support you in the study abroad planning process, connect you to additional relevant resources, and connect you with programs that meet your goals, interests, and needs. We look forward to supporting you as you begin your study abroad journey. Sincerely, Mireille Halley Study Abroad Advisor, Global Engagement Center Orange Coast College 2701 Fairview Road Costa Mesa, CA 92626 Office: 714.432.5940 Fax: 714.432.5191

Name*

First Name

Last Name

OCC Student ID#*

Email*

Are you*

Male Female Non-Binary

Did you know: Males are statistically very underrepresented in Study Abroad Programs

Cell Phone #*

Or Home Phone #

What is your major?*

What is your expected date of graduation from OCC?*

Or how many units have you completed at OCC?

During which academic term are you interested in studying abroad? (ex: Fall 2023 Semester)*

Are you planning to transfer to a University after OCC? Where?*

You might want to investigate how your chosen transfer university evaluates/counts study abroad transcripts/credits

Do you have a passport?*

Yes No No, But I've applied for one

Which country issued (or is issuing) your passport?*

What is your goal in Studying Abroad? How do you see it abroad complementing your academic and/or professional goals?*

Do you have an idea how you will pay for Study Abroad?*

No Idea I have the money already I have part of it, and a plan to scrape up the rest Hoping for scholarships I'm Pell Grant Eligible

Other:

check all that apply

Which academic topic or themes would you like to study while abroad?*

Are you considering a language based program abroad? (ie: French in Paris)*

Yes No

Please list language classes and levels you've taken in HS or college. *

If you have researched programs that interest you please list them here

Anything else you want to ask or tell us?