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MTSU Study Abroad in Israel Summer 2018 Application
Date: Name
Will you be an MTSU student in July 2017? Yes☐ No☐ Do you plan to register for the course? Yes☐ No☐Maybe ☐
MTSU only: M# # of hours earned GPA, Overall
MTSU only: Majors/Minors
Cell Phone Email DOB
Country of Citizenship Passport # Passport Expiration Date
Please list all previous travel abroad (locations and year of visit/residence):
Why do you want to travel to Israel with us?
How do you plan to fund this program (i.e. personal money, scholarships, financial aid, etc.)? Please be specific.
How did you hear about the Israel Study Abroad program?
From the itinerary, which site is of most interest to you?
From the syllabus, please summarize the course description.
Do you have any concerns about the sites we will visit or the course content? Yes☐ No☐ Maybe ☐
If yes/maybe, please explain.
Do you have any physical limitations that would prohibit you from walking 4-6 miles per day in the heat, hiking over rough terrain, or climbing? Yes☐ No☐ Maybe ☐ If yes/maybe, please explain.
Do you have any mental limitations that would hinder your ability to travel in an environment that differs from that to which you are accustomed, to experience different cultures, or to discuss difficult political issues?
Yes☐ No☐ Maybe ☐ If yes/maybe, please explain.
Payment Deadlines:
First payment: $1500.00, January 26, 2018 or Ten days after acceptance into program (whichever is later)
Second payment: $1500.00, February 23, 2018
Third Payment: Remaining Balance, May 18, 2018
**The program fee ($4000-$4500) covers airfare, all ground transportation in Israel, all lodging in Israel, admission to all sites, guide, breakfast & dinner daily in Israel, and trip insurance through iNEXT. Not included in fee: Tuition, passport fee, lunch, incidental expenses, transportation to Nashville airport, excess baggage fees.
Refund policy: The fees are not refundable. However, if a student withdraws from the program before March 1, reasonable efforts will be made to reimburse recoverable costs only. Students should not purchase an airline ticket or pay the iNEXT fee to MTAbroad as the flight and insurance are included in the program fee.
By signing below, I confirm the following (initial next to each statement):
____ I have carefully examined the details for the Israel Summer 2018 program online, including the itinerary and course syllabus.
____ I agree to the payment and refund terms and conditions stated above.
____ I attest that I answered all application questions accurately and thoroughly.
____ I understand that study abroad is not a classroom-based experience and that, as such, I will be learning on site and not via classroom lecture.
____ I have asked and received answers to any questions about the program and wish to be considered for participation.
Signature: Date:
Please return completed, signed application to Dr. Petersen, Todd Hall 231. Early applicants will receive priority consideration. Space is limited.