TheTelGezer Water System ExcavationProject
2016Season 21 May – 10 June
Volunteer Application Form
Name:Last / First / Middle
Current Mailing Address:
Numberand Street
City State/Province Zip/PostalCode Country
PermanentAddress (if different from above):
Phone: Home / ( ) / Work / ( )
Email:
Person to be notified in case ofemergency while you are abroad:
Name: / Relationship:
Address:
Numberand Street
City State/Province Zip/PostalCode Country
Phone: Home / ( ) / Work / ( )
Email:
Your Occupationor Fieldof Study:
Do youhave any continuing health problems orphysical limitations? If yes, describe:
Have youany backgroundand/or field experience inarchaeology? If yes, briefly describe below:
Do you have any skills/training that you think might be useful to the field project (e.g. registered nurse, CPR training, lifeguard, photography, Surveying, computer data processing, etc.)
______Full Program (3 weeks) $1800.00
______Partial Program: 1, 2, or 3 Weeks – Which weeks?______
Personal Information:Age: / Gender: / Date of Birth:
Dietary Restrictions:
Occupation: / Employer or School:
Major fieldof study (if a student):
What languages do youspeak?
SSN: / Place of Birth:
Country of Citizenship: / Marital Status:
Passport #: / Country of Issue:
Date of Issue: / ExpirationDate:
Note:Ifyou do nothave avalid passport, you mustprovide the passportinformation requested
above atleast two weeks prior to departure. Ifyou do have avalid passport, please attach a copyofthe information page. Passports must be valid for at least 6 months before entry date into Israel. No passports with an expiration date earlier than December 31, 2016 will be accepted for travel to Israel.
Academic Credit:Iam enrolling for academic credit at (checkone):
______New Orleans Baptist Theological Seminary
______Through my university / seminary
Iam registering for (check one):
______Graduate credits
______Undergraduate credits
References:
Please provide the names and contact informationof two references (preferably academic):
Name of 1st Reference:
Address:
Numberand Street
City State/Province Zip/PostalCode Country
Contact Phone: / ( ) / Is this ______Home or ______Work?
Email:
Name of 2nd Reference:
Address:
Numberand Street
City State/Province Zip/PostalCode Country
Contact Phone: / ( ) / Is this ______home or ______work?
Email:
Payment:
Iunderstand that Iam required to complete andsubmit the medical, insurance, andthe risk/conduct & behavior forms (either by mail or uponarrival to the excavation).
Iunderstand that a deposit of $500.00 is due by March 15; the balance of payment is due by April 20.
Each participant will be responsible for procuring their own Airline ticket for arrival at Ben Gurion Airport in Tel Aviv no later than Friday, May 20, 2016, and since we have a Jerusalem introductory tour scheduled for that Saturday May 21. The Gezer staff will pick up all volunteers at the airport. Please forward a copy of your itinerary to
Refunds:
Inthe event of cancellation of the project, participants will be granted a full refundof any payments made.
Inthe event of cancellation of participation by volunteers, the following refund policy will apply:
1)Cancellations effective before May 1will receive full refund.
2)Cancellations effective more thana weekbefore the beginning of plannedparticipation will
receive a refund of 50%of theirpayment.
3)Cancellations effective less thana weekbefore the beginning of planned participation, or during
participation, will not be refunded.
This refundpolicy is ineffect since we plan and pay for various services accordingto preplannedcontracts andagreements made with various entities. Thus, we must have sufficient priornotice of cancellations.
All cancellations must be done inwriting(email is acceptable)and must receive a returnanswer before they are effective.
Iunderstand and agree to the refund policy delineatedabove:
Signature: ______Date: ______
Return to: Dr. Dennis Cole,
New Orleans Baptist Theological Seminary
3939 Gentilly Blvd. | New Orleans, LA 70126
(800) 662-8701 | (504) 282-4455, ext 3248