Study Away Questionnaire Study Away Questionnaire Complete and submit this form before you meet with Tina Breakell, Director of International Education and Study Away. Student ID #*Name* First Last Class Year*Phone*Email* List previous travel experience, by yourself or with your family:*Experience with language(s) other than English:*What areas are you considering as a major or concentration?*What are your extra-curricular activities and interests? Campus jobs?*Do you have any specific concerns that you would like to address while searching for the program or preparing for the experience?*When are you planning to study away? Semester/Year?*Where are you planning to study away?*What are the major goals that you are hoping to achieve by studying away?*Please List 3 general dates/times that work for you to meet with the Director of Study Away.*Date/Time 1Date/Time 2Date/Time 3 The Study Way office will contact you directly to set up a meeting with the Director, which is required prior to going abroad. You should provide general dates/times (i.e. Monday mornings 9-11am). Once we have confirmed that you have attended an information session, we will send you an email to set up your appointment.