Nomination Form—UG Application to MBA Study Trips
Space is available to motivated and qualified undergraduates to participate in the MBA international trips. Programs typically run
over winter or spring breaks. Typically, 1-3 seats are open to undergraduate students—depending on the trip destination and
demand. MBA students have priority.
Interested undergraduate students must first petition to join an MBA study tour. That means you must be nominated (approved) by
the Assistant Dean, Undergraduate Program.
Once approved, you may move forward with the MBA application process. You will be required to participate fully in the
international study program, pre- and post-trip sessions and academic assignments. You must also abide by all registration,
travel/risk management and payment requirements and deadlines. You will work with Joliene Garlic and your faculty trip leader
regarding these matters. Refer to the MBA international trip website for details: http://www.xavier.edu/williams/mba/studyabroad/. You will be enrolled in an undergraduate section of the trip course.
ELIGIBILITY
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Students must be full-time undergraduate students
Students must be JUNIOR or SENIOR STATUS (55+ credit hours completed)
GPA must be 2.75 or better
21 years old at the time of the trip (preferred)
APPLICANT INFORMATION
I am applying to (please list trip)
Date of trip (spring/winter/date)
LAST NAME
FIRST NAME
CELL PHONE
E-MAIL
MAJOR(S)
CLASS (JR/SR)
BANNER ID
MALE
DATE OF BIRTH (DD/MM/YYYY)
CUMM. GPA
FEMALE
REFERENCES
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Recommendation by a faculty member (see form)
Personal Interview may be required
STATEMENT OF INTENT
In the space below, please provide a statement which expresses your intentions for participating in this MBA study tour. Include why you want to
study in this part of the world and how this program will enhance your academic studies, career preparation and/or personal enrichment.
SIGNATURE
I certify that the information provided in this application is complete and correct. Any misrepresentation may result in the expulsion of the
application from the program.
SIGNATURE
DATE
I also authorize Xavier to review my academic and/or disciplinary records as part of the
admissions process to this study abroad program.
INITIAL
WCB STUDY ABROAD REFERNCE FORM
STUDENT INFORMATION
APPLICANT
PROGRAM/TRIP
STUDENT INSTRUCTIONS
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This form should be given to a professor who knows you well and can comment on your qualifications and readiness for this study abroad
program.
Two references are required—one must be from a faculty member
Forward all recommendation forms to the WCB Undergraduate Office: Ms. Cynthia Stockwell, WCB Undergraduate Office, 120A Smith Hall,
Xavier University, 3800 Victory Parkway, Cincinnati, OH 45207-1221, stockwellc@xavier.edu.
(STUDENT) APPLICANT’S WAIVER OF RIGHT TO ACCESS
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The Family Educational Rights & Privacy Act of 1974 (as amended P.L. 93-380) allows a candidate to waive his/her right of access to
confidential statement written on his/her behalf. The university does not require you to make such a waiver as condition for admission. I
hereby waive my right of access to this recommendation:
NAME
SIGNATURE
DATE
NOTE TO FACULTY / ADMINISTRATOR REFEREE
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This study abroad program is an intensive, immersion program where students will explore the country’s historical, social, political, economic
and business environment.
Students on this program must demonstrate the highest level of maturity, integrity, openness to new ideas, problem solving and academic
skills.
PLEASE RATE THE APPLICANT ON THE FOLLOWING:
CRITERIA
Outstanding
Very Good
Good
Average
Below Average
n/a or cannot
evaluate
MOTIVATION / SERIOUSNESS OF PURPOSE
MATURITY
ADAPTABLITY / RESILIENCE / HANDLE STRESS
ACADEMIC
PERSONAL INTEGRITY / RELIABILITY
ABLE TO WORK WITH OTHERS / IN GROUPS
OVERALL / READINESS FOR PROGRAM
Recommend Highly
Recommend
Do Not Recommend
OTHER COMMENTS / OBSERVATIONS
For additional comments, please feel free to use back or attach a letter
REFEREEE
NAME
DEPARTMENT
PHONE (XU)
E-MAIL
How long have you known this student?
In what capacity?
SIGNATURE
DATE