Phone: (814) 865-6394
Fax: (814) 863-4789
Department of Architectural Engineering
104 Engineering Unit A
The Pennsylvania State University
University Park, PA 168021417
PROVISIONAL APPLICATION
Specialized Program in Architectural Engineering
University of Leeds
Email Address__________________________
Name______________________________________
Student Number____________________________
Age_______
Birth Date ______________________
All-University Average*_____________________
Note: Must expect to be 7th Semester
Fall 2003
Home Address*______________________________
University Address*_________________________
___________________________________________
_________________________________________
Home Phone*_______________________________
University Phone*________________________
Previous Foreign Studies___________________________________________________________________________
(Location)
(Dates)
I have read the General Announcement of the Foreign Studies program at the University of Leeds and wish to be
considered as a possible participant under the terms stated herein, but without making a binding commitment at this
time.
___________________________________________________________
Signature of Student
______________
Date
I endorse this application under the terms stated in the General Announcement on the Foreign Studies program at the
University of Leeds, but without making a binding commitment at this time.
____________________________________________________________
Signature of Parent
______________
Date
* Applicant is required to report changes as they occur to the AE Department, 225 Engineering "A", University Park,
Pennsylvania, 16802. Omission may result in exclusion of the application from further processing.
Applications must be returned by January 15, 2005