Florida COASTAL School of Law
SUMMER STUDY ABROAD PROGRAM– Clermont-Ferrand, France(“Program”) APPLICATION
Submit application in person or print and mail (1) completed application, (2) non-refundable registration fee of $300, and (3) letter of good standing(not required of FCSL students) by March 30, 2012, to:
Katharine Hartland, Program Director
8787 Baypine Road
Jacksonville, FL 32256
Office No. 516
E-mail:
Web site:
PLEASE ANSWER ALL QUESTIONS.
□FCSL Student □Non-FCSL Student
FCSL ID Number: ______Passport Number: ______
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1. U.S. SOCIAL SECURITY NUMBER
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2. NAME (LAST, FIRST)
3. MAILING/BILLING ADDRESS:
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STREET
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CITY STATE ZIP
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COUNTRY
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PHONE E-MAIL
4. DATE OF BIRTH: ______PLACE OF BIRTH: ______
MM/DD/YYYY
5. □ MALE□FEMALE
6. CITIZENSHIP: □U.S. CITIZEN □NON-RESIDENT ALIEN □PERMANENT RESIDENT
7. COUNTRY OF CITIZENSHIP, IF NOT A U.S. CITIZEN: ______
8. PERMANENT ADDRESS (if different from mailing address, above):
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STREET
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CITY STATE ZIP
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COUNTRY
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PHONE E-MAIL
9. NON-FCSL STUDENTS: LAWSCHOOL ADDRESS:
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NAME OF LAWSCHOOL
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STREET
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CITY STATE ZIP
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COUNTRY
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PHONE E-MAIL
10. NON-FCSL STUDENTS: NAME OF LAW SCHOOL REPRESENTATIVE TO WHOM A FINAL TRANSCRIPT SHOULDBE MAILED:
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11. LAW SCHOOL YEARS COMPLETED (BY MAY 29, 2012): □1 YEAR □2 YEARS
GRAD. DATE ______
12. LAWSCHOOLGRADE POINT AVERAGE (AS OF TODAY’S DATE): ______
14. EMERGENCY CONTACT:
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NAME
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STREET
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CITY STATE ZIP
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COUNTRY
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PHONE E-MAIL
IF YOU ARE A STUDENT AND ARE NOT ENROLLED AT FCSL, PLEASE
HAVE THE DEAN OR REGISTRAR FROM YOUR LAWSCHOOL SEND A LETTER OF GOOD
STANDING. THE LETTER SHOULD APPROVE THE TRANSFER OF CREDITS FROM FCSL
LAWSCHOOL TOWARD THE J.D. DEGREE AT THE LAWSCHOOL OF YOUR
MATRICULATION. LETTERS OF GOOD STANDING ARE DUE BY MARCH 30, 2012.
15. COURSE SELECTION: YOU MAY SELECT ALL COURSES, BUT AT LEAST FOUR CREDIT HOURS MUST BE SELECTED. TUITION IS $943PER CREDIT HOUR:
□Comparative Judicial Systems – Prof. Bradley Shannon – 2 credits
□Global Professionalism Skills – Prof. Karen Millard – 2 credits
□French Business Law – Prof. Allison Fiorentino - 1 credit
□European Union Law – Prof.Marie Elisabeth Baudoin – 1 credit
16. FINANCIAL AID: PLEASE INDICATE WHETHER YOU WILL BE REQUESTING FINANCIAL AID ASSISTANCE TO ATTEND THE PROGRAM:
□YES□NO
REGISTRATIONFEE DUE UPON SUBMISSION. APPLICATION DEADLINE IS MARCH 30, 2012. ENROLLMENT IS LIMITED. BALANCE DUE MAY 29, 2012 (BUT WITHDRAWAL DEADLINE IS APRIL 15, 2012). MAKE CHECKSPAYABLE TO FLORIDA COASTAL SCHOOL OF LAW.
Please note: Students who submit this application and then elect to not attend must complete a drop from and submit to the Registrar’s Office no later than April 15, 2012.Students who have not completed a drop form by this date will be financially liable for the tuition for the course(s).
□ I have enclosed my registration fee of $300 (check or money order). Thetuition balance must be remitted no later than May 29, 2012.
□I have enclosed full payment of tuition and fees.
( (a) tuition for 4 credit hours: $3,772; (b) tuition for 5 credit hours: $4,715; or (c) tuition for 6 credit hours: $5,658)
□I will be making payment via my credit card. I understand that a 2% convenience fee will be charged. Credit card payments must be made using the student web portal. Non-FCSL students should contact the FCSL Registrar to create a portal.
Student Information Sharing:
I agree that my name, address, telephone number and e-mail address may be given to other students registered forthe program.
Travel:
I understand that I am solely responsible for my own travel from the U.S. to France and to, from, and within the town of Clermont-Ferrand, including travel, lodging and meals that may be necessary to attend field trips in other parts of Europe. Field trips organized by FCSL or by the University of Auvergne are optional, and I may elect not to attend some or all of these trips.
Code of Conduct:
I agree to abide by FCSL’s Student Code of Conduct and any additional rules of conduct specific to this Program which may be provided to me and/or amended from time to time. In the event I fail to comply with the FCSL Student Code of Conduct or additional program rules of conduct, FCSL may immediately eject me from the Program, deny me credit for the courses I am taking during the Program, or otherwise take any other action permitted to FCSL under the FCSL Student Code of Conduct. FCSL shall not be required to make any refund of tuition due to action taken as a result of a student’s violation of the FCSL Student Code of Conduct or any additional program rules of conduct.
Release and Assumption of Risk
I agree to release FCSL from all liability, and I assume the following risk:
(1)In the event of an emergency that necessitates the administration of medical care, hospitalization, or surgery, I authorize FCSL and/or the University of Auvergne, through its authorized professors, representatives or agents or other administrators in charge of the Program, to secure any necessary treatment, including the administration of an anesthetic and/or surgery. I understand that such treatment shall be solely at my expense and I agree to reimburse FCSL for any expenses it may incur on account of such injury or treatment.
(2)I agree to release and hold harmless FCSL and the University of Auvergne, their officers, administrators, employees, professors, and any agent, tour organizer or arranger employed by FCSL or the University of Auvergne, from any and all claims and causes of action for damage to or loss of property, personal injury, illness or death arising during, in connection with, or immediately before or after the Program, including but not limited to any travel or activity conducted by or under the control of FCSL with regard to this program.
(3)I agree to indemnify and hold harmless FCSL, its officers, professors, administrators, employees and agents with regard to any claims or causes of action for damage to or loss of property, personal injury, illness, or death which was caused in whole or in part by me.
Housing Indemnification:
I agree and acknowledge that FCSL is not responsible for any housing or living arrangements during the Program, including dormitory rooms that may be available through the University of Auvergne/CROUS, and that FCSL shall have no liability whatsoever for any claim, injury, damage to property or any other liability related to my room and board while in France. I agree to indemnify and hold FCSL harmless for any damage to property, injury to person, or for any liability whatsoever related to my rental of a roomor other type of housing during the Program. In the event that CROUS, the University of Auvergne, or any other party charges FCSL for any damage to any housing rented by me, I agree to pay such charges immediately or to reimburse FCSL immediately for such charges, as necessary. Furthermore, I agree to pay any costs or expenses, including but not limited to attorney fees that FCSL may incur to enforce this agreement.
CERTIFICATION – REQUIRED
I certify that I have read, understood and agreed to the terms of the Program contained in this application. The information on this application is correct, and I understand that on becoming a participant in the Program I shall be subject to FCSL regulations and Program guidelines. I understand thatFCSL reserves the right to require withdrawal of any student as a result of unsatisfactoryperformance or behavior, academic or otherwise.
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SIGNATURE DATE
How did you hear about FCSL’s summer study abroad program?
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