Full name (last, first, middle):   

Local address: 

Local phone #:    

Email: 

Permanent address:

City, State, ZIP: 

Permanent Phone # (w/ area code):

Social Security #: Date of Birth (dd/mm/yy):

Year in School (Fresh, Soph, Jr, Sr, Grad):  

Years at MSUM:     Major: Minor:

Spanish classes taken at MSUM (check all that apply):

SPAN 201 Intermediate Spanish I (4) 

SPAN 211 Conversation (3) 
SPAN 202 Intermediate Spanish II (4) 

SPAN 212 Conversation II (3) 
SPAN 301 Spanish Grammar (4) 
SPAN 302 Spanish Conversation and Composition (4) 
SPAN 321 Iberian Culture and Civilization (4) or
SPAN 322 Latin American Culture and Civilization (4) 
SPAN 340 Introduction to Spanish Literature (4) 

SPAN 351 Phonetics and Phonology (4) 

SPAN 401 Advanced Conversation and Composition (4) 
SPAN 451 Survey of Spanish Linguistics (4) 
SPAN 341 Survey of Iberian Literature (4) 
SPAN 342 Survey of Latin American Literature (4) 

SPAN 421 Advanced Iberian Culture and Civilization (4) 

SPAN 422 Advanced Latin American Culture and Civilization (4) 
SPAN 443 Genres and Themes of Iberian/Latin American Literature (4) 
SPAN 444 Periods and Authors of Iberian /Latin American Literature (4) 
SPAN 490 Special Topics in Spanish Language, Literature or Culture (4)

Other Spanish courses taken at the University level:

Emergency Contact Information

Please provide us with a person to contact in case of emergency:

Full name (last, first, middle):   

Relationship (father. mother, etc): 

Address:

City, State, ZIP: 

Phone # (w/ area code):    email: 

Do you have a passport?  yes    no