-WPI Off-Campus Study Travel Information Form Academic Year

Transcription

1 -WPI Off-Campus Study Travel Information Form Academic Year All students intending to complete a project at a WPI project site are asked to provide the IGSD with information about their travel arrangements. This will notify the faculty advisor, on-site coordinator and IGSD staff of your expected arrival date and time and alert them if a problem arises. For some sites this information is needed in order to arrange to have students met at the airport. ****************************** You must bring your passport into the IGSD to be scanned, unless you are participating in a project program within the U.S. Name: Site: Term: Arrival on site: Arriving from (city): Mode of travel (air, train, bus, car): If traveling by air: Airline: Flight Number: Airport Destination: Departure time: Arrival time: Scheduled return date: Airline: Flight Number: Airport Destination: Departure time: Arrival time: If you plan to travel independently either before or after the program, please tell us your tentative plans: You must attach a copy of your travel itinerary provided by your travel agent or airline, in addition to completing this form. No handwritten itineraries will be accepted. 1

2 Off-Campus Students Health Update and Records Release Form Academic Year Name Project Site Term All students traveling off-campus to participate in a WPI program are required to carry medical insurance that is valid at the program site for the entire length of the program. Please verify this with your insurance company and list the name of your carrier and your policy number. Carrier Policy Number: Do you have any medical conditions that could affect you while off-campus of which you would like to make the IGSD aware? (i.e. epilepsy, diabetes, depressive episodes, etc.) Also, please list any changes in your health not noted on your medical records on file with WPI Health Services. Are you allergic to any medications? If so, please list them. List any prescription medicines you are currently taking. When traveling abroad it is a good idea to take a supply of your prescription medications sufficient to last for the length of the trip. Prescription medicines should always be kept in the original containers with the prescription label to avoid problems with customs. It is also important to take along a copy of the prescription from your physician, clearly written, in generic terms, and with an indication of the condition being treated. In the event of an emergency, please contact: 1. Name Relationship to Student Cell Phone#: Home Telephone: Work Telephone: 2. Name Relationship to Student Cell Phone #: Home Telephone: Work Telephone: I hereby authorize WPI health services to release my medical records to the Interdisciplinary and Global Studies Division in the event of a medical emergency while studying off-campus. I hereby acknowledge that it is my responsibility to contact my health insurance provider to determine that I am covered while at an off-campus project site. Signature 2

3 Protocol for WPI provided Cell Phones for Overseas Project Centers Students who participate in the overseas Global Perspective Program are required to carry a cell phone provided by WPI. It is expected that the following protocol will be followed and the students using the cell phones will assume proper fiscal responsibility. If students are unable or unwilling to comply with the protocol specified by the Interdisciplinary and Global Studies Division (IGSD), the IGSD and the on site faculty advisor reserve the right to prohibit that student s participation in the program. Procedure Each student will fill out an ATC Cell Phone Authorization Form (attached). Barbara Milanese (from the IGSD) will send approved names to ATC. Every student must meet all IGSD paperwork deadlines before names are sent to the ATC. Each student will be required to register at the ATC and sign a statement accepting responsibility for the cell phone. Each student is responsible for the cell phone assigned to him or her. The ATC will hold signing parties financially responsible for ALL AIRTIME and USAGE CHARGES, damage beyond normal wear and tear, and/or loss and/or any additional fees incurred. Upon return to campus and the return of the cell phone, each student will be expected to pay for ALL use of the cell phone. Any unpaid cell phones bills will result in a hold being placed upon the student s account and an additional processing fee. Reservations Make your reservation early for your cell phone. After you submit your form to Barbara Milanese in the IGSD office, you must go to the ATC to make your reservation with your WPI ID. At the time of reservation you must specify the dates and times for the pick-up and return of the equipment. If two people are responsible (one for pick up, one for return) BOTH must go to the ATC to register before leaving campus. If arrangements have been made for a faculty member to return the cell phone, then the faculty member must send confirming to the ATC (ATC@wpi.edu) before the cell phone will be released. Pick and Return deadlines will be strictly enforced. If the cell phone is not returned to the ATC by the agreed upon date, you will be charged a $50 per business day late fee. Picking up the cell phone You must have your WPI ID card in order to pick up the cell phone assigned to you. Using the cell phone while on site You must carry the cell phone with you at all times particularly when traveling on weekends or away from the project site. Faculty may call each of you randomly to insure your phone is with you and on (you will not be charged for these check up calls). You must supply the on-site faculty advisor(s) with a written itinerary if you plan to travel overnight at any time during the project experience. (The required form can be accessed at ) If you travel to a location in which your WPI cell phone does not function you must call the on-site faculty advisor upon arrival with a phone number at which you can be reached. You are financially responsible for ALL CALLS made to and from your cell phone. (Do NOT lend your phone to others as you will be the one paying for the call. Incoming calls from outside your immediate project center location will incur charges to your phone as well.) In EMERGENCY situations, the IGSD will approve calls that are made or received on your cell phone. Emergencies do not include calls to and from your onsite advisor, your sponsor or your teammates. It is always less expensive to use a land line for these types of calls. If you do have a true emergency, then you must write ( ) for approval of waiving the charge. If you have an emergency that requires use of the cell phone, please notify the IGSD via at phonebill@wpi.edu. You will need to describe the nature of the emergency and the date(s) any calls were made or received. If you do not do this within 72 hours of the emergency call the fees will not be waived. Charges per outgoing call are estimated as follows: If you call a number on-site you get an in-country roaming rate (ex. Bangkok to Bangkok) If you call a number off-site, you get charged the US roaming rate (ex. Bangkok to US) Your VoiceStream phone is a USA number see the attached chart for specifics. Charges per incoming call are estimated as follows: Incoming call from the same site (Bangkok to Bangkok) FREE to receive Incoming call from outside the site including USA Int'l Long Distance (varies by country usually very expensive!) Calls within the United States will be charged at.12 per minute. SUMMARY: WPI provides the phone. You are responsible for its timely return, damages or loss, and ALL CALLS. 3

4 ATC Cell Phone Authorization Form (One per person) Please turn in this form (completed) to Barbara Milanese in the IGSD BEFORE you attempt to make arrangements with the ATC. Student name: Student Local phone number: Student ID#: WPI Project site: Term: WPI address: Home address: of return: I authorize to pick up my cell phone for me. I have read the Protocol for WPI Provided Cell Phones for Overseas Project Centers and I understand that I am responsible for the timely return of the cell phone, any damages or loss, and ALL CALLS placed or received. Failure to return the phone by the agreed upon date will result in a late fee. Failure to pay for incurred expenses will result in a hold being placed on my academic account and an additional processing fee. I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. Participant Signature date date of birth* *If participant is under 18 years of age, both parents and/or legal guardians must also read and sign this form. I am the parent or legal guardian of the above Participant, have read the foregoing Protocol for WPI Provided Cell Phones for Overseas Project Centers (including such parts as may subject me to personal financial responsibility), am and will be legally responsible for the obligations and acts of the Participant as described in this Protocol for WPI Provided Cell Phones for Overseas Project Centers, and agree, for myself and for the Participant, to be bound by its terms. X Signature of Parent / Guardian X Signature of Parent / Guardian

5 Car Responsibilities at a project site If you choose to bring your own car or to rent a car, you assume all risks involved in the use of the car. The following paragraphs provide some general advice about car usage. If you use your own car: 1. Make sure you have valid insurance coverage. 2. Make sure you carry your insurance papers with you in your car. 3. Make sure you have a recent registration in your car and that it will not expire while you are at the project site. 4. If your car is registered in a state that requires a safety and/or emissions inspection, make sure it is up to date and will not expire while you are at the project site. If you rent a car: 1. The rental agreement is a contract between you and the rental company. Make sure that you read and understand the entire rental agreement. In particular, the rental agreement determines your liability in case of an accident or damage to your car, and any restrictions on the use of the car. 2. Make sure that you understand the insurance options being offered by the rental company, and that you select insurance coverage appropriate to your situation. If your or your parents automobile liability insurance covers you when you are driving a rental car, you may not need to purchase liability insurance from the car rental company. Check with your insurance agent Your credit card may cover you for damage to the rental car. Check with your credit card issuer. If you are planning to rent a car for a long period, you should make sure that your own insurance or your credit card will cover a long-term rental. 3. If you are involved in an accident or if your rental car is damaged, inform the car rental company right away. If you use a car: 1. Do not drink and drive! If you are cited for drunk driving or any other infraction involving drinking and driving, you will be on your own! WPI assumes no responsibility for your operation of your own vehicle or any vehicle you are traveling in while participating in the Program. 2. If you have an accident or are cited for any reason, tell your advisor(s) immediately! 3. Safety is the most important issue while using your car or being a passenger in a car while participating in the Program! 4. Bring an extra car key and either keep it in a safe place in your apartment or give it to someone you trust and will be available should you lose your key or lock yourself out of your car. I acknowledge that I have received, read and understand the above text describing car responsibilities while participating in the WPI Project Program. Name site term Signed date DO NOT COMPLETE THIS FORM IF YOU ARE GOING TO AN INTERNATIONAL SITE.

6 Onsite Travel Form On Site Travel Form E06 through D07 Name Destination & time of departure Cell phone number & time of return Mode of Transportation Roundtrip Train Bus Air Car Departing from the Site Information Time of Departure Departing from (name of airport, station, terminal) * Connection Information if applicable: Returning to the Site Information Returning from: Time of Departure Departing from (name of airport, station, terminal) * Connection Information if applicable: Name of hotel City and country Phone number Lodging (please call advisor with any changes to your reservations) Name of hotel City and country Phone number List other students who are traveling with you on this exact itinerary: Check this box if you are staying on site in WPI provided housing for the entire weekend. Student Signature Every student or group of students must turn this form into an advisor before 12:00 noon every Friday in other words, every student must be accounted for.

7 Request for Accommodations Congratulations on your acceptance to the WPI Global Perspective Program! We hope that you will find your experience to be exciting, challenging and rewarding. The Student Life Department works with the Office of Academic Advising to enhance access for and participation by students with documented physical, sensory, psychiatric and learning impairments. Each student bears the responsibility of initiating a disability-related request for accommodations, auxiliary aids and/or services. If you have needs or questions related to a disability, please fill out and return the bottom portion of this page to Natalie A. Mello, Director of Global Operations, Interdisciplinary and Global Studies Division. You will be contacted by JoAnn VanDyke, Director of Disability Services, to discuss your needs. I have a physical, sensory, psychiatric or learning disability and am interested in services available at WPI. Name Site accepted to: Phone WPI Box Number