Oklahoma & Nebraska Spring 2024 – Student Information Please provide the following information: Student Information Form OU/UNL General InformationPlease indicate which Program you are participating in.* University of Nebraska Interior Design University of Oklahoma Architecture University of Oklahoma Interior Design Name First Middle Last Permanent Street Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneWork PhoneEmail Gender Female Male This info is necessary for housing assignments. For other genders please contact AIA.Date of Birth MM slash DD slash YYYY Passport InformationName as it appears on passport (i.e. including middle names) Citizenship Passport Number Place of Issue (city, country) Place of Birth (city, state and country) Date of Issue Date of Expiration T-Shirt SizePlease SelectWomen's SmallWomen's MediumWomen's LargeWomen's X-LargeMen's SmallMen's MediumMen's LargeMen's X-LargeEmergency Contact InformationPlease supply two people whom we should contact in the event of an emergency.Contact OneName First Last Relationship Home PhoneWork PhoneCell PhoneEmail Contact TwoName First Last Relationship Home PhoneWork PhoneCell PhoneEmail Medical InformationVOLUNTARY - for Emergencies only. Medical info will not impact eligibility for enrollment.Personal Doctor's Name Doctor's Office PhoneInsurance Company Policy Number Study Abroad Health Insurance Program Yes No Additional Medical Information - VoluntaryYou may add any physical or mental health info you think is relevant - consider what would help us accommodate special needs (i.e. difficulty walking, etc.) this space is provided for confidential, voluntary information and will not impact enrollment - you may also offer additional info after arrival.Please let us know if you have a food allergies (i.e. nut allergy, seafood allergy, etc.) or have dietary preferences (i.e. vegan, vegetarian, pescatarian, kosher or halal, etc.) This information is very important as we will book group dinners and inform restaurants of your preference in advance. If you do not provide this information, accommodations cannot be guaranteed.Additional Personal InformationYou may add any additional comments here this space is provided for voluntary information and will not impact enrollment - you may also offer additional info after arrival.Language ExperienceWe would like to know about your experience with Italian.I have taken Italian language courses in (choose one): High School University I have never taken Italian I took Italian courses for:I would describe my Italian language skills as:Graphic Expression (Architecture only)COMPLETE IF APPLICABLE TO YOUR STUDY PROGRAM We would like to know about your talents and ambition.I feel I have a particular talent/skill in the following media: Sketching / Freehand Drawing Painting Writing Video / Film Drafting (digital) Modeling (digital) Collage Photography Drafting (manual) Modeling (physical) Other (list below)I hope to develop the following skills while I am abroad. Δ
