INCOMING EXCHANGE/VISITING STUDENTS PROGRAM APPLICATION INSTRUCTIONS (Effective as of 09/21/2016)

Transcription

1 GENERAL INSTRUCTIONS INCOMING EXCHANGE/VISITING STUDENTS PROGRAM APPLICATION INSTRUCTIONS (Effective as of 09/21/2016) 1. EXCHANGE: The deadline to submit exchange program applications is the last Friday of October for Spring term exchanges and the last Friday in March for Fall term exchanges, unless otherwise indicated. Applicants applying after the stated deadline will be considered at the discretion of The Office of Global Engagement. 2. Read all instructions thoroughly and follow carefully to avoid delays. Applications must be completely filled out and all required supplemental items submitted in a single.pdf file. 3. All applications are to be filled DIRECTLY on this PDF file. Once completed, you may scan (as a.pdf) and to goglobal@erau.edu or mail/ship to: Embry-Riddle Aeronautical University Office of Global Engagement Bldg. 273, The HUB, Suite S. Clyde Morris Blvd. Daytona Beach, FL USA 4. If you have any questions, contact us at goglobal@erau.edu. SUPPLEMENTAL ITEMS All supplemental items are to be sent with the application, in English, or certified translation provided. Unless specified Exchange or Visiting Student, requirement applies to all applicants. 1. Copy of your official transcripts (unless you have already supplied it through GE3). 2. EXCHANGE: One page (double spaced) essay describing why you would like to study at ERAU and what you expect to get out of your experience. If you are applying through GE3, you can use the essay required for their application to fulfill ERAU s requirement. 3. EXCHANGE ONLY: Your Academic Plan completed and signed by home institution advisor (located at end of application). 4. A resume (CV) (unless you have already supplied it through GE3). 5. One passport-sized photo, on a white background (unless you have already supplied it through GE3). 6. A copy of your passport (unless you have already supplied it through GE3). 7. Financial Affidavit and supporting documentation, notarized where required. Read (carefully) and follow instructions at top of Affidavit of Financial Support. 8. Completed Medical Report Form and Immunization Records. 9. Insurance documentation 10. Proof of English language ability. If you come from an English speaking university, we will need a document stating such with the signature and stamp from your international coordinator or faculty director. Otherwise, English language requirements are as stated on our website under application instructions.

2 OFFICE OF GLOBAL ENGAGEMENT Incoming Exchange and Visiting Student Program Application (Revised: 09/21/2016) ERAU ID#: Program Type: Foreign Institution Term Year GE3 Exchange Student Spring Bilateral Exchange Student Fall Visiting Student (Study Abroad) Fall & Spring Summer Last Name: First Name: Middle Name: (As it appears on your passport or birth certificate.) Gender: Male Female Country of Citizenship: Passport Number: Main field of study at ERAU: Permanent (or parental) address: Street: Date of Birth (mm/dd/yyyy): City and Country of Birth: Passport Expiration (mm/dd/yyyy): Level of classes you intend to take: Undergraduate Graduate N/A T-shirt size: Mailing address (if different from permanent): Street: City: State: City: State: Zip Code: Zip Code: Country: Country: Telephone number (including country/area code): Telephone number (including country/area code):

3 HOME INSTITUTION S STUDY ABROAD ADVISOR INFORMATION, THIS IS WHERE YOUR TRANSCRIPTS WILL BE MAILED. Name: Phone (Including country/area code): Fax: Complete Mailing Address: LIST ANY MEDICAL CONDITIONS, CONCERNS OR COMMENTS BELOW. IF NONE, CHECK BOX. None IN CASE OF EMERGENCY, LIST THE NAMES OF TWO DIFFERENT CONTACTS: Name 1: Name 2: Relationship: Telephone number: (including country/area code) Relationship Telephone number: (including country/area code) LANGUAGE SKILLS 1. Native Language: 2. Other Languages Spoken: List any languages studied or acquired and what level of proficiency (Beginner, Intermediate, Advanced, Working Knowledge, Fluent, or Native Speaker).

4 SUPPLEMENTAL INFORMATION FOR FORM DS-2019 Country of legal permanent residence: Sponsorship period (mm/dd/yyyy): From: To: The proposed category of this exchange visitor is: Exchange Visiting Student Specific current field of study: If you are currently in the USA, what is your status? (Type of visa) FINANCIAL SUPPORT AND DS-2019 In order to issue a Form DS-2019 required to obtain a J-1 visa, ERAU s Compliance Office is required to document proof of financial responsibility for Exchange Visitors. We estimate the average monthly living expenses at $1,200 per month or $14,400 per year. This does not cover the expenses of any dependent(s) who may accompany the Exchange Visitor to the U.S. Exchange visitors may need to show personal funds to cover the expenses of their dependents who will accompany them to the U.S. You must submit one or more of the following documents as proof of support: An appointment letter in the Exchange Visitor s name from Embry-Riddle Aeronautical University, a government agency, international organization, or other sponsor. It should specify the length of sponsorship and the amount of money provided (including tuition when appropriate), living expenses, insurance, dependents, books, academic supplies and other personal items. You may use private or self-sponsorship for the remainder. Embry-Riddle Aeronautical University will require an official bank statement in you or your sponsor s name and a notarized affidavit of support from personal sponsors, amount of money provided, living expenses, insurance, dependents, books, academic supplies, or other personal items. Please ensure that you provide financial statements accordingly to reflect amounts stated in the Affidavit. For compliance purposes, Exchange Visitors are required to show proof of health insurance coverage for themselves and each dependents. We will require proof of coverage no later than upon arrival for students. Lack of coverage will be seen as a violation of the Exchange Visitor Program regulations subjecting participants to program termination and return to their home country.

5 STATEMENT OF STUDENT RESPONSIBILITY The following statement is given to all students studying abroad in Embry-Riddle Aeronautical University sponsored programs. Your signature below indicates your acceptance of the rules and regulations as detailed. Student Conduct In all Embry-Riddle Aeronautical University sponsored programs, students are expected to behave in a mature, responsible manner, and at all times abide by University regulations and the policies embodied in the Embry-Riddle Aeronautical University Student Standards of Conduct. The Office of Global Engagement has the authority to dismiss a student from the program at any time, who is following a course of action or behavior harmful to the student, to others, or to the program, including violation of Embry- Riddle Aeronautical University rules and regulations. In such a case, the student will be asked to leave Embry- Riddle Aeronautical University, including program housing, and will not be permitted to attend classes. No refunds will be due from Embry-Riddle Aeronautical University, and return transportation costs in such circumstances are the responsibility of individual students. Embry-Riddle Aeronautical University does not condone and strives to prohibit the unlawful possession, use, distribution, or manufacture of illicit drugs and alcohol by students on its property or as part of any of its activities. Specific statements of the University s polices can be found in the Student Handbook. Student Liability It is understood and agreed that Embry-Riddle Aeronautical University, cooperating organizations, or individual faculty leaders and directors do not assume liability for any injury, loss, damage, accident, delay, irregularity or additional expense arising from the use of any vehicle or services, or from strikes, weather, quarantines, sickness, government restrictions or regulations, or from any act or omission of any railroad, motor coach, airline, or other transportation company, or for any cause whatsoever. Nor is any responsibility assumed for loss or damage to a participant s baggage or personal possessions. All such losses or expenses will be borne by the participant. ACCEPTANCE AND RELEASE STATEMENT I understand that I am ultimately responsible for my own behavior during this Exchange Program, and am aware that any unruly and disturbing behavior, or acts in violation of Embry-Riddle Aeronautical University s (ERAU) Student Standards of Conduct, may be grounds for immediate expulsion from the program. Financial Responsibility: I understand that I am financially responsible for providing my meals, visa fees (if applicable), and any other miscellaneous costs involved in studying abroad. Assumption of Risk: I understand that participating in the Program entails inherent risks in the various activities which I will participate in during this program. I have been given the chance to ask questions concerning the Program. All such questions have been answered to my satisfaction. Having read this form, I am fully aware of the risks and hazards associated with the Program, and hereby elect to voluntarily participate in the Program. I voluntarily assume full responsibility for any risks of loss, property damage or personal injury, including death, that may be sustained by as a result of participating in the Program, unless it is caused by the gross negligence or willful misconduct of ERAU, its officers, trustees, agents, employees or volunteers (the Releasees ). Liability Release: In consideration for ERAU allowing me to participate in the Program, I agree I will not sue the Releasees. I release the Releasees from any and all liabilities, claims, demands, actions, causes of actions, costs and expenses of any nature, whatsoever, arising out of any loss, damage, or injury, including death, that may be sustained by me or to any property belonging to me, arising from

6 the Program and its activities or while upon the premises where the Program is being conducted, excepting those claims arising from the gross negligence or willful misconduct of the Releasees. Indemnification: I agree to indemnify and hold harmless the Releasees from and against any loss liability, damage or costs, including court costs and attorneys fees, that Releasees may incur arising from my involvement in the Program, excepting those claims arising from the gross negligence or willful misconduct of the Releasees. Statement of Physical Fitness: I am physically fit and in a condition that will allow me to participate fully in the Program. I maintain medical insurance that covers me for accidents and illnesses while I am participating in this program. Releasees are relying on my warranty of my physical condition. I understand the Releasees have not made, nor will make, any investigation into my physical fitness or ability to participate in the Program and Releasees are relying on my warranty of my physical condition. I assume full responsibility for payment of medical expenses not covered by insurance incurred as a result of my participation in the Program. Emergency Medical Treatment: I grant the Releasees permission to authorize emergency medical treatment as they deem appropriate, and agree that such action by the Releasees shall be subject to the terms of this Agreement. I understand and agree that the Releasees assume no responsibility for any injury or damage that might arise out of or in connection with such authorized emergency medical treatment. Program Changes: I understand that ERAU reserves the right to make cancellations, changes or substitutions in the program in cases of emergency or changed conditions, or in the best interest of the group. Should ERAU cancel the program, full refunds, if applicable, will be made unless the cancellation is due to political, natural, technological or other problems beyond its control in which case ERAU will be able to refund only uncommitted and recoverable funds. Insurance: I understand that ERAU requires that all students maintain medical insurance while participating in the Program. The participant shall be financially responsible for any and all medical expenses arising from the program. In addition, I understand that the payment for medical expenses may have to be advanced by me and reimbursement sought later from the insurance carrier. ERAU also requires that students planning to operate a motor vehicle obtain auto liability and collision insurance that will cover them during their participation in the program. ERAU also recommends that participants obtain personal property insurance to cover losses to personal property while in the Program. Behavioral Expectations: I understand that all students are subject to ERAU regulations and program guidelines and the laws of the host country. In the event I violate any of these, or I sustain academic failure, or I exhibit behavior which is considered by ERAU to be detrimental to myself, other students, or to the Program, ERAU shall have the right to dismiss me from the program while retaining all tuition and fees, when applicable. I understand that I shall be responsible for any extra expense I may incur as a result of this dismissal. It is my express intent that this Agreement shall bind the members of my family and spouse (if any), my estate, heirs, administrators, assigns or personal representatives. I agree that this Agreement and any claim arising from my participation in the Program shall be construed in accordance with the laws of Florida, without regard to its conflict of law provision. The courts in Volusia County, Florida and shall be the forums for any lawsuits arising from the program or incident to this Agreement. The terms of this Agreement shall be severable, such that if a court of competent jurisdiction holds any term to be illegal or unenforceable, the validity of the remaining portions shall not be affected thereby.

7 RELEASE STATEMENT SIGNATURE PAGE (To be printed, completed, and submitted to the ERAU Office of Global Engagement) I have read and completed all sections of this application. I have attached the required documentation for my financial status. I declare I have truthfully stated the financial arrangements to support my exchange program/visiting student period at Embry-Riddle University. I understand that the law requires F and J-1 Exchange Visitors to hold health and accident insurance. I agree to purchase the required insurance for me and my dependent(s) to be effective immediately upon arrival to the U.S. I understand that by not having medical insurance, including repatriation, I will be terminated immediately from the F or J-1 program. Upon arrival at Embry-Riddle, I will check in with the Office of Global Engagement and the SEVIS Compliance Office and bring my DS-2019, passport, VISA and proof of insurance. Failure to do this upon arrival can lead to termination from the F or J-1 program. I acknowledge that certain risks are inherent in the various activities which I will participate in during this program. I understand that my host university and ERAU as well as their faculty and staff have no control over these risks, and are not responsible for my personal welfare beyond ordinary precautions taken for the safety of students. I therefore agree to assume all responsibility for any and all claims for damages including medical expenses, personal injury or death, disability, loss of wages, loss of earning capacity, and property damages which I may incur or may be incurred against me during my participation in this program. In signing this Agreement, I acknowledge that I have read this Acceptance and Release Agreement, including the Statement of Student Responsibility and any attachments, understand the terms and information in each, and agree to be bound by their terms. I further acknowledge that I sign this Agreement voluntarily. By signing this application, I authorize the release of my official transcript to be sent to the host institution. I have read the above and have willingly signed this document with full understanding of its purpose. Print Name: Exchange Visitor s Signature Date (mm/dd/yyyy)

8 EXCHANGE VISITOR PROGRAM HEALTH INSURANCE REQUIREMENT CERTIFICATION FOR F, J-1 SCHOLARS AND J-2 DEPENDENTS (Please complete and bring to the Compliance Office upon your arrival.) Today s Date: (mm/dd/yyyy) Date of Arrival in U.S.: (mm/dd/yyyy) Exchange Visitor: Last Name First Name Middle Initial Telephone Number (including area and country code): I (the exchange visitor) certify that I have obtained health insurance for myself (and my dependents), if applicable, during my stay in the Exchange Visitor Program at Embry-Riddle Aeronautical University and that my health insurance meets the minimum requirements outlined below: (a) Insurance which covers the exchange visitor for sickness or accident during the period of time that an exchange visitor participates in the sponsor s exchange visitor program. Minimum coverage shall provide: 1) Medical benefits of at least $100,000 per accident or illness 2) Repatriation of remains in the amount of $25,000 3) Expenses associated with the medical evacuation of the exchange visitor to his or her home country in the amount of $50,000 and 4) A deductible not to exceed $500 per accident or illness. (b) An insurance policy secured to fulfill the requirements for this section: 1) May require a waiting period for pre-existing conditions which is reasonable as determined by current industry standards. 2) May include provision for co-insurance under the terms of which the exchange visitor may be required to pay up to 25% of the covered benefits per accident or illness; and 3) Shall not unreasonably exclude coverage for perils inherent to the activities of the exchange program which the exchange visitor participates. (c) Any policy plan or contract secured to fill the above requirements must, at a minimum, be: 1) Underwritten by an insurance corporation having an A.M. Best rating of A- or above, an Insurance Solvency International, LTD (ISI) rating of A-I or above, a Standard & Poor s Claims-paying ability rating of A- or above, a Weiss Research, Inc. rating of B+ or above, or such other rating as the Department of State may from time to time specify, or 2) Backed by the full faith and credit of the government of the exchange visitor s home country, or 3) Part of a health benefits program offered on a group basis to employees or enrolled students by a designated sponsor, or 4) Offered through or underwritten by a federally qualified Health Maintenance Organization (HMO) or eligible Competitive Medical Plan (CMP) as determined by the Health Care Financing Administration of the U.S. Department of Health and Human Services. (d) Federal, state or local government agencies, state colleges and universities, and public community colleges may, permitted by law, self-insure any or all of the aboverequired insurance coverage.

9 (e) At the request of a non-government sponsor of an exchange visitor program, and upon a showing that such sponsor has funds readily available and under its control sufficient to meet the requirements of this section, the Department of State may permit the sponsors to self-insure or to accept full financial responsibility for such requirements. (f) The Department of State in its sole discretion, may condition its approval of self-insurance or the acceptance of full financial responsibility by the non-government sponsor to secure a payment bond in favor of the Department of State guaranteeing the sponsor s obligations hereunder. (g) An accompanying spouse or dependent of an exchange visitor is required to be covered by insurance in Sec (a) above. Sponsors shall inform exchange visitors of this requirement, in writing, in advance of the exchange visitor s arrival in the United States. (h) An exchange visitor who willfully fails to maintain the insurance coverage as set forth above while a participant in an exchange visitor program or who makes a material misrepresentation to the sponsor concerning such coverage shall be deemed to be in violation of these regulations and shall be subject to termination as a participant. (i) A sponsor shall terminate an exchange visitor s participation in its program if the sponsor determines that the exchange visitor or any accompanying spouse or dependent willfully fails to remain in compliance with this section. I hereby certify that I understand and accept that my participation in the Exchange Visitor Program will be terminated if International Student Services determines that I or any accompanying spouse or child of mine in J-2 status willfully fails to remain in compliance with the U. S. Department of State regulations governing required health insurance coverage for Exchange Visitor program participants. Exchange Visitor Signature Date

10 ACADEMIC PLAN Student Name: HOME INSTITUTION INFORMATION Institution Name: Current Major: Home Institution Advisor Name: DIRECTIONS: Fill in the tables on the following page according to the courses you wish to take at Embry-Riddle found in the course catalog at Please list the ERAU Course Number (Ex. BA 201) and the ERAU Course Title (Ex. Principles of Management), followed by the course that is equivalent at your home institution (Ex. BUS 200). The Exchange Visitor as well as their home institution advisor must sign this plan. List your top 5 courses that you wish to take during the semester, followed by 3 alternative courses. We will do our best to accommodate your course requests.

11 COURSE SELECTON ERAU COURSE NUMBER ERAU COURSE TITLE HOME INSTITUTION EQUIVALENCY COURSE ALTERNATIVE COURSES ERAU COURSE NUMBER ERAU COURSE TITLE HOME INSTITUTION EQUIVALENCY COURSE Home Advisor Signature Print Name Date Exchange Visitor Signature Print Name Date S:\SHARED\Officers\Study Abroad\Daytona Beach\3 Semester Yearlong\2_Incoming\Incoming App Global Engagement.NEW.docx