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Summer 2025 - Northern Ireland
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Summer 2025 (exact dates to be determined)
Please complete this form to express interest in the faculty-led trip to Northern Ireland.
Personal Information
Merrimack ID*
First Name*
Last Name*
Merrimack Email Address*
Emergency Contact Name*
Emergency Contact Phone*
Emergency Contact Email*
Passport Information
Note: Your passport must be valid for six months from your date of departure. If you do not have a valid passport, please consult the information on
this page
an apply for a new passport or renewal as soon as possible.
Do you have a valid passport?*
Do you have a valid passport?*
Yes
No
Citizenship*
Passport Number*
Passport Expiration Date*
Passport Expiration Date*
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
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9
10
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22
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25
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27
28
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30
31
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
Please upload a copy of the bio page of your passport
Academic Information
Class Standing*
Freshman
Sophomore
Junior
Senior
Anticipated Graduation Semester*
Spring
Fall
Summer 1
Summer 2
Summer 3
Anticipated Graduation Year*
2024
2025
2026
2027
2028
Academic Advisor Name*
Do you have any questions about the trip to Northern Ireland? (optional)
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