Undergraduate Certificate Application

Submitted by euceadmin on Tue, 2011-08-02 10:41

Please indicate the certificate(s) for which you are applying:

West European Studies

European Union Studies

Both

First Name:

Last Name:

PeopleSoft ID:

Pitt E-mail:

The e-mail address to which all official University correspondence is sent.

Personal E-mail:

If you use an alternate e-mail address, please add it here.

Permanent Address

Address Line 1:

Address Line 2:

City:

State:

Postal Code:

Phone Number:

School/Department:

Major:

Minor:

Expected Graduation:

Study Abroad

Location:

Time Period: From:

Time Period: To:

Are You Considering Graduate School?:

Yes

If Yes, In What Field?:

What language(s) do you study or intend to study?:

List courses you are now taking or have taken to qualify for the certificate:

What other further courses might you wish to take?:

How did you learn of the European Union Center of Excellence/European Studies Center?:

Local Address

Address Line 1:

Address Line 2: