Cuba Immersion                     

Program Application


Application Submission:

Complete this application on-line.  Print it out and send with a check in the amount of $100 made payable to Spring Hill College.  Applications are to be mailed to Justin Daffron, S.J. at 4000 Dauphin Street Mobile, Alabama 36608.

Personal Data:

Full Name

Current Address
Current City, State and Zip Code
Work Phone
Current Phone
FAX
E-mail
Home Address
Home City, State and Zip Code
Home Phone
Emergency Contact Name
Emergency Contact Phone
Date of Birth
Sex Male   Female

Academic Information:

 Current classification

 School currently attending

Major or area of academic interest

 I wish to register for up to six credit hours in

3 hrs of Spanish Credit 

3 hours of Sociology 

3 hours Political Science 

No Credit 

Students not currently enrolled at Spring Hill College will be required to complete supplemental application materials.