Strasbourg Study Abroad Program

Note that registration is complete when the $250 non-refundable deposit is received.

If you are bringing your spouse and/or child(ren), you must also fill out this form for each family member.

First Name
Last Name
City, State, ZIP
Day Phone
Cell Phone
Social Security Number
(no dashes)
Passport Number
Passport Expiration Date
Date of Birth
(no spaces - mmddyyyy)
Male or Female
If you are not a citizen of the U.S., are you a permanent resident of the U.S.? 
Yes - if yes, submit a copy of your permanent resident card to Mary Bunch.*

Country of Birth
Are you a
Law Student
Program (JD, MA, LLM):
Regent Law Student

If "Law Student," law school or university attending
No. of Semesters Completed by next June
Emergency Contact Name:
Emergency Contact Number:
Note: If you are a law student who is not attending Regent University School of Law, then please have your Dean's office mail a "Letter of Good Standing" on official school letterhead.
Pay Deposit Online Now
Pay by Check Later*
Amount $
Are you bringing your spouse and/or child(ren)?
Yes No

*If applicable, send checks, letters of good standing, and permanent resident cards to Strasbourg Study Abroad Program, Attn: Mary Bunch, RH 225, Regent University School of Law, 1000 Regent University Drive, Virginia Beach, VA 23464.