Southern University and Agricultural and Mechanical College

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Study Abroad Program Student Survey

International Program Attended
Semester, Year
Name

(First Name)

(Last Name)
Gender
Male
Female
E-Mail Address
Date of Birth

(mm/dd/yyyy)
First Language
Second Language
Proficiency Level of Second Language
Campus Address
Phone Number (Local or Cell)

(xxx-xxx-xxxx)
Was this your first trip to the country your study abroad program tool place?
Circle answer
Yes
No
How was your study abroad experience funded?
Personal Savings
Paid for by parents
Scholarship/Fellowship
Other
((Check all that apply))