Name

Date of Birth

Email Address

Major (if decided)

Local Address

Cell Phone (if applicable)

Permanent Address

Letter of Recommendation from:

How did you learn about this program?

Are you currently a LASP minor? (You answer will not affect the decision in regard to this award)

Number of semesters/years you have studied Quechua

Other languages you have studied and number of semesters/years you have studied them

Please evaluate your current proficiency in Quechua. Please check the most appropriate line for the category listed below

Unable to function in the spoken language
Able to satisfy basic survival needs and maintain very simple conversation on familiar topics
Able to participate effectively in the most formal and informal conversations on practical and social topics and on professional topics in restricted contexts
Able to use the language fluently and accurately on all levels pertinent to professional needs