Colgate University Off-Campus Extended Study Application

Tropical Ecology Extended Study to Costa Rica: May 20 – June 11, 2013

COLGATE UNIVERSITY OFF-CAMPUS EXTENDED STUDY APPLICATION

Name ______Study Group______Spring 2013

Countries of Citizenship______Class ____ Colgate ID ______

Concentration ______Minor ____ Dean ______

CU Phone # ______CU Box # ____ Email ______

Parent / Guardian’s Name ___

Home Address Home Phone ___ Cell/Work Phone ______Fax ___

Parent / Guardian’s email ___Other Parent / Guardian’s Name (if appropriate) ___

Home Address Home Phone ___

Cell/Work Phone ______

Fax ___

Other Parent / Guardian’s email ___

Have you previously participated in a Colgate Study Group or Extended Study? ( ) Yes ( ) No

If yes, please indicate which one(s), along with the semester and year you participated.

____

____

What other Colgate Study Groups or Extended Studies are you currently applying to (if any) ?

If you have learned or studied any language that does not appear on your Colgate transcript, please fill out the table below.

Language Years studied/known Reading Ability Speaking Ability

If the extended study to which you are applying has prerequisite courses which you have not already taken, please indicate the course(s) and which semester you intend to take them.

Summer work and/or study experience:

______Foreign travel and/or residence abroad:

Do you have a current passport? ( ) Yes ( ) No If yes, the expiration date is ______.

If you do NOT have a valid passport (or if your passport will expire within six months of the end date of your intended study group), you should apply for one immediately. Current processing time for passports is up to four weeks, and a passport in hand is required before you can apply for a visa. Please visit for more information. This is not necessary for domestic

programs.

References: List two or three faculty/administrators who are able to speak about your character and your academic abilities.

Name: Name:

Dept/Phone Dept/Phone

Name:

Dept/Phone

ESSAY

Please type and attach a 1-2 page essay explaining why you wish to join this extended study and what contribution it will make to your education. Also include, if you wish, any characteristics or qualities you possess that you feel would benefit the extended study group.

When writing your essay please include answers to the following question. Keep in mind that the extended study has a required seminar class as well. Please single space answers and confine to one page.

1)Why do you want to take this class?

2)What are you considering doing after college?

3)Have you traveled in developing countries before? If yes, where have you traveled?

TRANSCRIPT

Please also attach an unofficial copy of your transcript to this application. (Unofficial transcripts are attainable from the registrar’s office, or you can print your own from Colgate’s portal website.)

OFF-CAMPUS STUDY GROUP AND EXTENDED STUDY APPLICATION POLICIES

(1) The study group or extended study director will consult your administrative advisor (dean) during the study group selection process, and, if you are selected as a member of the group, will continue to do so periodically until the time of departure to ensure your eligibility for participation in the study group/extended study.

(2) If you have already participated in a Colgate study group or extended study and are now applying for a second study group or extended study experience, you may be given last priority in the student selection process.

(3) If you are applying to two or more Colgate study groups or extended studies and/or an Academic Leave of Absence for the same semester, you are permitted to accept enrollment in ONLY ONE.

(4) If accepted to a study group or extended study, you will be given an Acknowledgement of Risk and Responsibility form, a Parental Acknowledgement of Student Participation form and a medical form, all of which must be completed and signed in order for you to participate in the study group.

Photography Waiver

For purposes of the federal Family Educational Rights and Privacy Act, the New York Civil Rights Law, and as otherwise legally required, I give permission to Colgate University to use my name and photographs taken of me at Colgate University off-campus programs or events in Colgate University publications, advertisements, presentations, or Web sites.

( ) Yes ( ) No _

Applicant’s signature Date

Agreement and Signature

I certify that the information on this application is complete and accurate.

______

Applicant’s signature Date