Nepal Experience Application Form
May 2000
Name: Last __________________ First ____________________
Social Security Number __________________
Class standing F__ S__ Jr___ Sr___ Gr ____
In-State _________ Out-of-State __________
Oxford Address _______________________
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Phone Number _______________________
Desired City and Airport to Fly from_______________________________
Parents' Name: Last __________________ First ____________________
Last __________________ First ____________________
Parents' Address _____________________________________
_____________________________________
_____________________________________
Phone Number _______________________
Briefly explain why you want to enroll in this class: _________________________________
______________________________________________________________________________
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(Use additional paper if needed)
Department of Sociology, Gerontology, and Anthropology
Miami University, Oxford, Ohio 45056
513-529-3432/2628