ࡱ> LOKO I=bjbj`` 4@ e eo   IIIII]]]8D4]A,     +++++++$.1+9I+II  +FI I ++)h* Oa|)+,0A,*|52j52 *52I*l^L++GjA,52 : Student Application for Participation in a Faculty-Led Study Abroad Course Student Name: Student ID #: Student Major: Student Adviser: Home/Cell Number:___________________________________________ Age___________ Course Number:_____________________________ Number of Credits:_____________ Course Instructor/Group Leader(s):_______________________________________________ Students anticipated date of trip: Students anticipated graduation date: Students total credits earned at time of study abroad: Students cumulative grade point average: Course Instructors Approval To be completed by the course instructor I have met with the student listed above regarding his/her intention to participate in this faculty-led program. I have discussed all necessary information with the student. Course Instructors Signature: ______________ Date: Adviser Approval To be completed by Adviser and Registrar I have met with the student listed above and discussed course options and academic implications of participating in this faculty-led program. Adviser Signature: Date: 1 Registrar I have met with the student listed above and discussed course options and academic implications of participating in this faculty-led program. ________________________________________________________________ Date:_______________________________________ Student Central Approval I have met with the student listed above and have discussed all billing and financial aid implications of participating in this faculty-led program Date: Student Acknowledgement To be completed by student I hereby acknowledge that I have met with the persons indicated above and understand the financial and academic implications of participating in this faculty-led program. I hereby make formal request of logo to participate in this faculty-led program I have indicated above. Student Signature: Date: Committee use only Date received: Student Affairs recommendation: % Approve % Deny Committee Action: % Approve % Deny Committee Signature: Date: 2 Faculty-Led Program Withdrawal Policy If a student chooses to withdraw from a Keystone College faculty-led program, he or she must inform the faculty leader and Study Abroad Coordinator in writing immediately. In such an event, the following policies apply: If an accepted student chooses to withdraw prior to a program's commencement: He or she will be responsible for paying any unrecoverable program costs that the College or the program has incurred on his or her behalf. Such costs may include, but are not limited to: pre-paid meals, pre-paid room or housing reservation deposits, airline deposits or airline tickets, bus rental fees, and payments for guides. Thus, even if the student has not yet paid the full program balance and does not attend the program, he or she may be responsible for paying these unrecoverable program costs. Therefore, it is in the student's best interest to notify the faculty leader and Study Abroad Coordinator immediately upon deciding to withdraw in order to minimize unrecoverable expenses made on the student's behalf. If a student chooses to withdraw after a program's commencement for any reason, including academic or conduct: No refunds will be given. In addition, any student who withdraws before completion of the program may not be eligible to receive academic credit from the program. If a student is required to return to the U.S. after a program's commencement due to serious illness, death, or death within the immediate family: The College will make every effort to refund recoverable costs to the student. If a student chooses not to participate in a program activity (such as a field trip, excursion, cultural event, included meals, etc.): No portion of the program cost will be refunded. If a student is dismissed from a program due to behavioral, academic, legal, or other related issues: No refunds will be given. Students will also be responsible for additional costs associated with sending them home (flight, transportation, etc.). Note: Students receiving financial aid should consult with Student Central for information about how withdrawing from a program would affect their federal, state, or institutional aid. Faculty-Led Program Cancellation Policy Because student safety is of critical importance, logo reserves the right to cancel any College sponsored program in a location that is considered unsafe by the College or for which the U.S. Department of State has issued a Travel Warning. The Study Abroad Coordinator regularly reviews information provided by the U.S. Department of State and monitors other sources, such as announcements from the Overseas Security Advisory Council (OSAC), for information about the countries where Keystone students are or will be studying. In such an event, the following policies apply: If Keystone cancels a program for safety reasons prior to departure or after commencement of the program: The College will make every effort to refund recoverable program costs to the participants. Unrecoverable program expenses (e.g., airline deposits, excursion expenses, housing fees or reservation deposits) cannot be refunded. If Keystone cancels a program after it has commenced due to safety concerns, an emergency, or a natural disaster: The College will make every effort to help students complete the academic work from the program and, depending on the circumstances, possibly earn the intended academic credit from the program. Whether or not this is possible depends largely on the particular program, the circumstances of the academic work of the program, and the length of time remaining in the program after the official cancellation date. If Keystone cancels a program for reasons other than safety, including under-enrollment: The College will make every effort to refund recoverable program costs to the participants. Note: Student Central will review program cancellations on a case-by-case basis for students who are receiving financial aid. Because full refun%+7JKLMZ_npqsʹ﹥{k{k[{N@N@heh!f>*OJQJ^Jheh!fOJQJ^JhaSh_5>*OJQJ^JhaSh!f5>*OJQJ^JhaSh!f5OJQJ^JhaShOJQJ^Jh!f5CJOJQJ^JaJ&haShk5>*CJOJQJ^JaJ how5>*CJOJQJ^JaJ hb 5>*CJOJQJ^JaJ&haSh!f5>*CJOJQJ^JaJ h|>5>*CJOJQJ^JaJKLMrs8 9 " # T U V W t $&dPa$gdaS$a$gd|>$a$gdaS$a$gd$a$gdaS   " L Q R T U V ¸…wj\w\j\w\jRhaSOJQJ^JhaShy>*OJQJ^JhaShyOJQJ^JhaSh_>*OJQJ^JhaSh!f>*OJQJ^JhaSh|>>*OJQJ^JhowOJQJ^JhaSh|>OJQJ^Jh|>OJQJ^JhaSh!fOJQJ^Jh (OJQJ^Jheh)OJQJ^JheheOJQJ^Jh)5>*OJQJ^JV j t % ; N O P m n o ~ xj\jOhaSh1<.OJQJ^JhaSh;6OJQJ^JhaSh1<.6OJQJ^JhaShVi5OJQJ^JhVi>*OJQJ^JhaSh|>>*OJQJ^JhViOJQJ^JhaShViOJQJ^Jh|>OJQJ^JhaSh|>OJQJ^Jh|>6OJQJ^JhaSh|>6OJQJ^JhaSh|>5OJQJ^Jh|>5OJQJ^Jt O P _ ` $&dPa$gdaS$a$gdaS$a$gdVi$&dPa$gd|>$a$gd|> 2 [ ^ r w ~ $ ( ) * T j k l Ķ}reeeZZZh~<5OJQJ^JhaSh JOJQJ^Jh)5OJQJ^JhX]5OJQJ^Jh J5OJQJ^Jh(*5OJQJ^Jh|>5Oϴ󲹳Ƿϴ󲹳;>*ϴ󲹳1<.>*ϴ󲹳پϴپϴ󲹳1<.OJQJ^Jh JOJQJ^J ( ) * k l IJKST_`ay$&dPa$gdaS$a$gd J$a$gdaS$a$gdX]l JKTY^aby>?AvùùàÕylll_RllhaShViOJQJ^JhVihViOJQJ^JhaShyOJQJ^JhaSh 6OJQJ^JhaSh 5OJQJ^JhVi5OJQJ^JhaSh >*OJQJ^Jh~<>*OJQJ^JhViOJQJ^JhaSh OJQJ^JhaSh1<.5OJQJ^Jh~<5OJQJ^Jh~<h~<OJQJ^Jh~<OJQJ^JAB|~"$a$gdX]$a$gd(*$&dPa$gdaS$a$gdaSZ^nr~  "仭仈}rh[NhC\h)OJQJ^JhC\hX]OJQJ^Jh~<OJQJ^Jh)>*OJQJ^Jh|>>*OJQJ^Jh JOJQJ^JhaSh;5OJQJ^JhaSh;OJQJ^JhaSh_>*OJQJ^JhaSh_OJQJ^JhaSh_5OJQJ^JhaShy5OJQJ^JhaShyOJQJ^JhaShy>*OJQJ^J"nf_A\]^_`ab -DM gd)$ & Fdx-DM [$a$gd~<dP-DM gd#gd -D@&M gd#g"ndW_U^A:BCFGIJ[_ab>O "!4!<:=;=üެàހom_haSh)>*OJQJ^JU h~<h~<5B*mH phsH h~<h)5B*mH phsH h)5B*\mH phsH h JB*mH phsH h~<B*mH phsH h) hvh)h)B*mH phsH hvh~<B*mH phsH hvh)B*mH phsH #hvh)5B*\mH phsH $ "!9=:=;===>=@=A=C=D=F=G=H=I=$a$gd(*dx-DM [$gd#g$ dx-DM [$^a$gd~<$ & Fdx-DM [$a$gd~<ds are often not possible, students may wish to consider purchasing trip cancellation insurance that can be obtained through many travel agents or insurance companies. 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