THE CAPA LEARNING ABROAD PROGRAM

Transcription

1 THE CAPA LEARNING ABROAD PROGRAM ApplICAtIon FoR AdMIssIon Your Application The admissions review process begins once we have received ALL relevant application materials at CAPA by the application deadline (see below right for deadline dates). Applications are not normally accepted after the deadline. If an exception is made, an additional $100 late fee must accompany your application. Remember to make a copy of all the materials you send CAPA. Complete applications are reviewed on a rolling basis. Applicants are notified of the admission decision approximately two weeks after the complete application is received. It is wise to apply early and well before the stated deadline as the CAPA Program may fill before the deadline. Submitted documents will not be returned to applicants. Additional Reuired Materials A Personal Essay is reuired from all students in addition to the attached forms. The personal essay should address any particular academic challenges faced and goals for studying abroad. Internships If you are applying to do an internship, please also complete the internship application found at the CAPA.org website. Internship applications must be turned in with your program application. Return Application Materials to: CAPA 210 Union Warf Boston, MA Student Accounts Telephone: Application Checklist Student Information (two pages) Housing Form Professor Recommendation Authorization & Evaluation Health Information Form Release Form Official transcript from each college or university you have attended since high school $300 non-refundable fee (this consists of a $50 non-refundable administrative fee plus a $250 deposit which will be applied to your program fees.) Make checks payable to CAPA International Education. Personal Essay Internship application, if applicable Classes: Phenomenal! I took British Pop Culture, London Underworlds, and International Marketing- I was so satisfied with these classes, they were some of the most interesting classes I have ever taken. STUDENT, CAPA LONDON PROGRAM The CAPA staff is amazing. We love them and they make us feel like we are at home when we get here in the morning until the moment we leave at night. STUDENT, CAPA FLORENCE PROGRAM Please be aware that failure to sign the signature pages means your application cannot be processed. Signatures are reuired on pages 3, 5, 6, 7 & 9. 1

2 Student Information CAPA does not discriminate on the basis of sex, race, color, creed, disability, sexual orientation, national origin, or ethnic origin. Inuiries regarding compliance with eual opportunity legislation may be directed to CAPA, PO Box 55087, Boston, Massachusetts ; telephone or ; or to the Director of the Office for Civil Rights, Department of Education, Washington, D.C. permanent Contact Information please use your complete name as it would appear on your passport. CAPA will use the information below to send you important information. Please inform us immediately of any changes, including changes. program Information Mr. Ms. Last Name First Name Middle Initial Date of Birth / / M M D D Y Y Permanent Address Line 1 Permanent Address Line 2 City State Zip Code Country Telephone Cell phone Primary Secondary Please indicate where & when you would like to study abroad with CAPA. Check all that apply: o london o Summer o Summer o Florence o Fall 2009 o Spring 2010 CAPA communicates freuently by . Be sure to list an address you check regularly. Current College Information Current Address Line 1 Current Address Line 2 City State Zip Code Country Telephone Can be reached at college address until: / / M M D D Y Y Home College or University Cumulative GPA on a 4.0 scale Major 1 Major 2 Minor Standing When Program Begins Fr. So. Jr. Sr. Other Colleges Attended (Include Dates) Internships With CApA o o I intend to enroll in an internship with CAPA I have completed the CAPA internship application passport Information U.S. Citizen Non-U.S. Citizen (specify) U.S. Alien Resident #A Do you have a passport for the duration of the program that is valid for 6 months after the program ends? Yes Country of Issue Currently applying Please see section 7 of the Release regarding your responsibility for obtaining all travel documents. Emergency Contact Information 1. Name Relationship Day Phone Evening Phone Address 2. Name Relationship Day Phone Evening Phone Address Please see section 1 of the Release regarding permission to share information. optional Information Asian Black or African American I am applying to other programs in addition to CAPA. Please List: How would you describe yourself? (select one or more) American Indian or Alaska Native Hispanic or Latino Native Hawaiian or Other Pacific Islander White 2

3 Student Information continued Name of Applicant Home College or University Course Choices Please note that some sections may be full at the time of application. CAPA will endeavor to give all applicants their first choice. CAPA reserves the right to enroll students into their second choice courses and will notify each student if this is necessary. First Choice Courses Second Choice Courses Course Code Course name Course Code Course name source of Interest How did you learn about the program to which you are applying? (Please check all that apply.) CAPA Brochure Study Abroad Publications CAPA Alumni Friend CAPA Representative Study Abroad Websites CAPA Website Study Abroad Office CAPA Poster Study Abroad Fair Parent Professor Other (Specify) disciplinary Information The existence of a disciplinary record or current disciplinary sanctions does not preclude admission but will be considered in the overall evaluation of the application.your answer may be verified with your home institution. Students currently on probation extending beyond the start date of the CAPA program will not be admitted. Are you currently on disciplinary probation? Yes No If yes, please attach a brief statement of explanation. Does your probation extend past the start of the CAPA program date? Yes No Student Signature CApA school of Record through the University of Minnesota The University of Minnesota is the School of Record for CAPA. I understand I will be temporarily admitted to the University of Minnesota as a non-degree seeking student for my term(s) abroad and that all CAPA coursework will be recorded as resident credit on the University of Minnesota transcript. I understand I will be reuired to complete the Transcript Reuest Form to be sent to me upon my acceptance to the CAPA program. IMPORTANT: To ensure acceptance of CAPA program credit recorded on the University of Minnesota transcript, you should discuss your proposed program of study with the appropriate official at the college or university you expect to attend upon your return. Neither CAPA nor the University of Minnesota can be responsible for ensuring credit transfer. I understand that I am fully responsible for completing the reuired Transcript Reuest Form and for understanding the credit transfer process at my home college or university and any future universities I may attend. If I fail to ensure receipt of the necessary form or to submit this form to CAPA by the deadline, I will be ineligible to receive credit through the University of Minnesota. Student Signature Application Fee payment Applications received after the published deadlines must also include an additional $100 late fee. Check or money order for the Application Fee is enclosed Please charge my credit card: Mastercard Visa (no other cards accepted) Credit Card Number Expiration Date Card Holder Name Card Holder Address City State Zip Card Holder Day Phone Card Holder Evening Phone Card Holder Signature 3

4 Housing Form Full name Term Year Date of Birth / / M M D D Y Y Gender Terms you will be studying abroad: Spring Semester Summer Session Fall Session Please indicate your housing preference: london: Shared Student Apartment Homestay Florence: Shared Student Apartment Homestay (semester only) Host Family Information - applies only to homestay programs with local families: I would prefer to stay with a family: with without no preference pets children General Information, Health & preferences 1. Do you smoke? Y N 2. Homestay only: Would you accept placement in a household with a smoker? Y N 3. Do you have allergies? Y N If yes, please specify: 4. Do you have any special dietary reuirements? Y N If yes, please specify: Vegetarians should be aware that not all of the foods you eat at home will be available overseas. 5. Apartment only: Would you like to room with someone in particular? 6. Is there any information CAPA should know about your physical condition that you did not indicate on your Health Information Form? 7. Any further comments on your needs or preferences? Please note CAPA will try to meet any reuests but cannot make any guarantees. 4

5 Professor Recommendation Name of Applicant Home College or University CAPA Program Location Term Year to the student: Please sign the authorization and give this recommendation form to a professor who knows you well and has taught you at the college level, preferably in your major. Your professor should forward the completed form either to you, your on-campus study abroad advisor named below: I hereby authorize: to provide a reccomendation. Under the provision of the Family Educational Rights and Privacy Act of 1974, I waive my right of access to this recommendation and understand that the information provided will be used only for the purposes for which it was prepared. or to: CApA International Education 210 Union Warf Boston, MA Signature Date to the professor: The individual named above has applied for a program of study abroad with the Centers for Academic Programs Abroad. Please provide your opinion of the applicant s ability to pursue university-level coursework in a foreign country. After completing this form, please place the recommendation in a sealed envelope with your signature across the seal and return it to the student, the study abroad office, or CAPA (at address above). Which of your courses has the student taken? How long have you known this applicant? Considering all the students you have taught, how would you rate this applicant on a combined measure of academic and personal performance? top 10% recommend this student without reservation. upper 25% recommend this student with reservation. upper 50% do not recommend this student. lower 50% Name Signature Date Position or Title Department Comments Please use this section or additional pages to add any information that you feel would help CAPA gain a better understanding of this applicant. _ College or University Telephone 5

6 Authorization and Evaluation Name of Applicant Home College or University CAPA Program Location Term Year I. student Authorization To the student: Please sign this authorization form and give it to your on-campus study abroad advisor. The undersigned campus official must be authorized to approve college credit transfer. Under the provision of Family Educational Rights and Privacy Act of 1974, I waive my right of access to this authorization & evaluation and understand that the information provided will be used only for the purposes for which it was prepared. Student Signature Date II. College Authorization and Evaluation GPA information below must be completed and signed by the Registrar/ Transfer Affairs Office. The remainder of this section can be completed by the applicant s study abroad advisor and sent to: CApA International Education 210 Union Warf Boston, MA Cumulative GPA /4.0 If GPA is not calculated on transcript, please calculate here: Student s rank in class in a total class of students The application of the above-named student is being submitted with my approval. Name Signature Date Title College or University Telephone Fax The transcript for this student should be sent to the following office and address: Comments Please use this section or additional pages to give us your evaluation of the applicant s abilities and suitability for the program to which s/he has applied. If you need to know of admissions decisions by a certain deadline, please contact your CAPA Representative and we will try to accommodate you. disciplinary Information * (check only one option) This student is currently not on disciplinary probation. This student is currently on disciplinary probation. The official college record stating the details is enclosed. This student s disciplinary record has been reviewed and approved for study abroad by an appropriate official at my institution. I do not have access to this student s disciplinary record. * The existence of a disciplinary record or current disciplinary sanctions does not preclude admission but will be considered in the overall evaluation of the application. If probation extends past the CAPA program start date, the student will not be admitted. 6

7 Health Information Form It is important that CAPA be aware of your health-related needs and/or concerns. We encourage you to consider the importance of these matters as you plan to go abroad. This information is not used to determine eligibility for the program. Name Program Location Term Abroad 1. Your general state of health: Excellent Good Fair Poor 2. Please describe any general health concerns you have at this time. 3. Please list any serious medical conditions for which you have been (or are currently being) treated. 4. Have you ever had (if yes, please give details of the condition and treatment on back): Heart trouble or blood pressure problems? YES NO Asthma or any other respiratory ailment? YES NO Stomach or intestinal problems (ulcers, etc.)? YES NO Allergic reaction to any medications? YES NO 5. Do you reuire any regular medication? If yes, please describe conditions and reuirements. 6. Have you ever been or are you currently being treated for any mental, emotional, or nervous disorder? If yes, please describe. 7. Name, address, and telephone of your physician or practitioner: 8. You will need health insurance coverage for the period you are away from your home institution. You will receive World Student Insurance coverage through this program. However, should you have additional insurance coverage which you have arranged yourself that will cover you from the time you leave your home university until your time abroad is over, please list the details below. Other coverage: Policy holder (parent, etc.) Insurance company name and policy # I understand that pre-existing health conditions may impact the uality and safety of my education abroad experience. I also realize that is my responsibility to contact my physician or health practitioner about conditions which may be affected by my change of location. _ Signature of Applicant Date 7

8 Payment Schedule and Cancellation Policy Important: Please review carefully and retain for your records. 1. program payments When paying program fees by check, please write the name that appears in your passport and indicate which term you are making the payment for on the bottom of your check. 2. Important deadlines You are responsible for making payments by the appropriate deadlines. Please make a note of these dates to avoid incurring late fees or being dropped from the program: Application and Deposit Complete applications are due 85 days prior to the start of the program and must be accompanied by a payment of $ (this consists of a $50 non-refundable administrative fee plus a $250 deposit which will be applied to your program fees). If your application is not accepted, you will be refunded the $250 deposit. Program Fees Program fees must be paid in full by 70 days before the start of the program. Financial aid students: Please see section 5 below. 3. late Fees A late fee of $100 will be applied to all applications received after the deadline dates listed above. Please note that acceptance to the program after the deadline dates is subject to availability. A late fee of $100 will be applied to all accounts with an outstanding balance 70 days prior to the start of the program. Note: If the deadline date falls on a non-business day, payments must be made before the deadline date. 4. Automatic Cancellations At 60 days prior to the start of the program: Applicants who have only paid the $ deposit will be automatically dropped from the program. At 46 days prior to the start of the program: Applicants with an outstanding balance will be automatically dropped from the program. The cancellation fees listed in section 6 will be applied. At 30 days prior to the start of the program: Applicants on Financial Aid with an outstanding balance beyond their Financial Aid disbursement amounts may be automatically dropped from the program. The cancellation fees listed in section 6 will be applied. If you have been dropped from the program and wish to be reinstated, full payment must be received along with a reinstatement fee of $175 and any additional land costs. Reinstatement is always subject to availability. 5. Financial Aid Students receiving financial aid to cover some or all of their program fees should submit the Financial Aid Disbursement form, signed by the financial aid office, by the 70-day payment deadline along with the $300 deposit and 30% of the program fees. The balance will become due at 30 days prior to the start of the program. 6. Cancellation policy Cancellations can only be accepted in writing, or by signed fax, and cannot be accepted by or telephone. The effective cancellation date is the postmark on the notification or the date of receipt of a signed fax. Refunds are calculated according to the following schedule and are mailed within 30 days of receipt of the written cancellation. Withdrawal date Cancellation Fees More than 60 days prior to departure $250 deposit 46 to 60 days prior to departure 25% of the program fee and the $250 deposit 22 to 45 days prior to departure 50% of the program fee and the $250 deposit 21 days or fewer prior to departure 100% cancellation penalty 7. Returned Checks A $50 processing fee will be charged for any check returned to CAPA due to insufficient funds. If your check is returned and your replacement check is not received by your deadline, you will incur any applicable late fees. Checks will not be re-deposited to the bank. 8

9 Release Form In this contract, CAPA shall mean the CAPA International Education, LP, a Massachusetts corporation, and its past and present employees, directors, officers, stockholders, members, agents, representatives, subsidiaries, parents and affiliates. The Institution shall mean the sponsoring organization, college or university, and its past and current officers, employees, affiliates, agents or representatives. I understand and agree to the following: REFUnd InFoRMAtIon. CAPA makes financial commitments on behalf of students well before the start of the program. Full refunds are not possible after the full payment due date. Partial refunds, less confirmation deposit, will be given according to the cancellation policy listed in the Payment Schedule and Cancellation Policy. Please note that partial refunds may not be possible. 1. PERMISSION TO SHARE INFORMATION. I give the CAPA and my home institution permission to communicate with each other and my parents or other emergency contact person regarding all issues surrounding my education-abroad experience. This may include but is not limited to student account information, student conduct issues, health and safety, or academics; such contact may occur before, during or after the program. 2. If, in the sole discretion of the Institution or CAPA, at any time my behavior is deemed unacceptable, I may be expelled from the program and/or sent home at my own expense or that of my parent/guardian if I am a minor, and I shall not be entitled to receive a refund for any services not received. I hereby acknowledge and agree that if I break any law during my participation in the program I may be subject to prosecution by local law enforcement authorities, and that CAPA has no obligation or duty to defend me in any proceedings or to otherwise provide me with any assistance in connection therewith. 3. I recognize that participation in the program entails certain risks to my property and person that in certain circumstances can be serious. I freely and knowingly assume those risks. In addition, I hereby fully forever, irrevocably and unconditionally release, remise and discharge CAPA International Education, LP. and all its past and present employees, directors, officers, stockholders, members, agents, representatives, subsidiaries, parents and affiliates (collectively CAPA ) from any and all claims, charges, complaints, demands, actions, causes of action, suits, rights, debts, costs, damages, executions, obligations, liabilities, and expenses (including attorneys fees and costs) (collectively claims ), of every kind and nature relating to or arising from any cause whatsoever, including without limitation from: (A) CAPA s negligence or other acts or omissions, (B) any sickness, injury, or accident that I may suffer (including those which result in my death) during my participation in the program, (C) any loss of or damage to any physical property, whether owned by me or a third party, (D) any errors or omissions contained in any brochure, application or any other literature I have received from CAPA or the institution, and (E) any delays in bookings or the making of travel arrangements or the non-confirmation or acceptance of any bookings, except for claims relating to my personal injury, death or other bodily harm directly caused by a deliberate wrongful act of CAPA or the Institution. 4. CAPA shall have the right, at any time and in its sole and absolute discretion, to cancel any program or make any changes or alterations in route, accommodations, price and/or details in the event of any program being rendered impossible or inadvisable in CAPA s sole discretion, by weather, strikes, war, civil unrest, terrorism, acts of god, government interference or any cause whatsoever that is beyond CAPA s control. Any and all expenses incurred as a result thereof shall be my responsibility. 5. I hereby agree and acknowledge that under no circumstance shall CAPA be obligated to pay any amounts hereunder to me or to any third party relating to CAPA s liability hereunder or relating to the program in excess of the aggregate amount received by CAPA from me, or on my behalf, in connection with my participation in the program. 6. I hereby agree to indemnify, defend and hold CAPA harmless from any Claims brought against or incurred by CAPA arising from or relating to any of my acts or omissions while participating in a CAPA program. 7. I hereby agree and acknowledge that it is my personal responsibility to obtain all passports, visas and reuired travel documents in order to enter each of the countries on my itinerary. I understand that if I am unable to obtain the necessary travel documents, or do not have them with me at the time of travel, I will not be entitled to a refund except as described in the agreement. 8. I hereby agree and acknowledge that CAPA shall not be responsible or liable for my well-being at any time that I am in my accommodations, during periods of independent travel or any other time period that is considered free time away from activities or events that are specifically authorized by CAPA. I understand that CAPA and the institution are not responsible for the acts or omissions of persons or entities outside their control, including without limitation, the acts or omissions of any airlines, surface transportation companies, including, without limitation, any car service companies, rental car companies, taxicabs, train service companies, any member of my or any other participant s homestay family, hotels, hostels, apartments, accommodation providers and other suppliers of trip services, and all of their respective employees, personnel or other agents. I hereby unconditionally release CAPA and the institution from all claims arising out of or relating to the acts or omissions of third parties not within CAPA or the institution s control. 9. Once the CAPA Program has started, no refunds will be made for sightseeing, excursions, accommodations or other services in which I have declined to participate. 10. CAPA may use statements made by me, photographs and video footage of me for publicity and advertising purposes. 11. CAPA is not responsible for any costs arising from the loss or theft of any of my personal property at any time, including my airline ticket. 12. This agreement shall be governed by the laws of the Commonwealth of Massachusetts. Any controversy or claim arising out of or relating to this agreement, or the interpretation hereof, shall be determined by arbitration to be conducted before the American Arbitration Association in Boston, Massachusetts in accordance with the Commercial Arbitration Rules of the American Arbitration Association and the laws of the Commonwealth of Massachusetts. I hereby irrevocably submit and consent to and acknowledge and recognize the jurisdiction of any federal or state court located within the Commonwealth of Massachusetts for the purpose of enforcing any arbitration award. 13. In the event any provision herein shall be held void, invalid, or inoperative, such decision shall not invalidate or otherwise affect, in any respect, any other term or terms of this agreement. If any provision of this agreement shall be determined, under applicable law, to be overly broad in duration, geographical coverage or substantive scope, then such provision shall be deemed narrowed to the broadest term permitted by applicable law. 14. I hereby agree and acknowledge that I have carefully read the Payment Schedule and Cancellation Policy, understand the contents herein, freely and voluntarily assent to all of the terms and conditions hereof, and sign my name of my own free act. 15. I hereby agree and acknowledge that I have carefully read this Release, understand the contents herein, freely and voluntarily assent to all of the terms and conditions hereof, and sign my name of my own free act, and that I have had an opportunity to fully discuss and review the terms of this Release with an attorney. signatures I, or my parent or guardian if I am under 18 years of age, have read and understand this Release of liability and agree to be bound thereby. Any controversy or claim arising out of, relating to, or interpreting this Release shall be determined by arbitration to be conducted before the American Arbitration Association in Boston, Massachusetts, in accordance with the Commercial Arbitration Rules of the American Arbitration Association and the laws of the Commonwealth of Massachusetts. Applicant s signature: Date: Parent/Guardian s signature: Date: Campus Coordinator s signature (if reuired by the Institution): Date: 9