Mastering English: International Summer in New York City Application For High School Programs

Transcription

1 Mastering English: International Summer in New York City Application For High School Programs Step 1: Complete the online questionnaire on the following website: tinyurl.com/mpblor4 Step 2: In order to participate in the American Language Institute s Mastering English: International Summer in NYC, students must submit the following forms to the American Language Institute before the application deadline, see dates below. Download the forms, complete them, and them to. The forms can be completed and signed electronically or downloaded and completed by hand. Application Deadlines Application deadline May 1, 2015 Housing deposit deadline May 15, 2015 Tuition and program fee deadline May 22, Applicant Information First name Last name (Family name) of birth (Month-date-year) Gender Native language Country of birth Country of citizenship 2. Contact Information Permanent home mailing address Street address Apartment Number City, State Country Postal code Home phone number Mobile number address Continued on next page

2 1. Summer Program Which Summer Program are you applying for? American College Experience (July 5 July 25) - High School students American College Experience (July 26 August 15) - High School students New York City Experience (July 5 July 25) - High School students 2. Educational History Name of High School, Country, s attending/attended [month/year-month/year], of graduation [month/year]

3 Photograph and Creative Release Form Program Title: American Language Institute Mastering English: International Summer in New York City Class Title This agreement is made between ( you ) and the NYU School of Professional Studies in connection with use of your image and text prepared by NYU School of Professional Studies, of all or a portion of the material. For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, you hereby grant NYU School of Professional Studies permission to: Use your likeness (still or video), your voice, and/or text written by you or about you: (i) on the NYU School of Professional Studies and NYU websites, (ii) in NYU School of Professional Studies and NYU newsletters and publications, (iii) in direct marketing and marketing campaigns, (iv) in advertisements (print, digital, video, and online), (v) by NYU School of Professional Studies and NYU produced media outlets (i.e. NYU TV), (vi) by external news media outlets and production facilities, (vii) in a live simulcast on University or non-university servers, and/or (viii) in social media. (a) You hereby agree that the NYU School of Professional Studies shall own all rights to the material, including without limitation, the right to exploit the material consistent with the paragraph above, for educational, commercial, and marketing purposes, as confirmed by your written approval below. (b) This agreement shall be construed in accordance with the laws of the State of New York. If you are in agreement with the foregoing, please sign where indicated below. Name (print) Signature Signature of parent or guardian if student is 18 years of age or younger Phone number Address Country

4 2015 American Language Institute s Mastering English: International Summer in NYC Contract Please read the following terms carefully. Your signature at the end of this Contract indicates your understanding of and willingness to abide by the rules and policies governing the Mastering English: International Summer in NYC Programs (hereafter International Summer in NYC) set forth in this Contract and online in the International Summer in NYC Handbook. Failure to comply with the rules and policies of International Summer in NYC may lead to disciplinary action up to and including dismissal from the program without refund of tuition or fees. International Summer in NYC is an academically rigorous program in which each student s active and supportive participation is highly valued. The program is intensive, involving a variety of classroom activities, homework assignments, and chaperoned program activities that will be intellectually demanding and time-consuming. Students in the program will have the opportunity to contribute to and benefit from participation in a unique community of peers and must be respectful of others and thoughtful about the impact of their actions upon their community. It is very important to understand that the dedication and focus upon one s academic work is what makes International Summer in NYC successful. Mastering English: International Summer in NYC Programs Rules and Policies The following is a summary of some of the significant rules and policies of International Summer in NYC. In addition to the rules and policies set forth below, students and parents also should review the International Summer in NYC Handbook, which contains more detailed information and links to administrative policies and procedures, academic standards, student conduct standards, and residential policies. Program Regulations: Students must attend a mandatory orientation. Students must attend classes as stipulated in their course syllabi. Students are expected be on time. This applies not only to class time, but also to field trips, group excursions, projects, homework, use of equipment and space, etc. Upon enrollment in International Summer in NYC, students will be charged a student program activity fee to cover activities and excursions in the afternoons that are connected to classroom content. Participation in these events is mandatory. The program activity fee covers the cost of each event but not related additional costs such as transportation or souvenirs. Students will be charged a $ University program activity fee to cover the costs of evening and weekend events that have been planned to enhance the students overall experience. The program fee cover the cost of each event but not related additional costs such as transportation or souvenirs. For university organized events in the evening, students will have the opportunity to R.S.V.P. for these events in advance, and waitlists and rush space will be available to give each student an opportunity to participate. The university events will be run by residence hall staff, and all students residential and commuter are encouraged to participate. Participation in events is not mandatory but highly recommended. Residential Students: The residential component complements the academic program. Additional residential policies are set forth in the International Summer in NYC Handbook. A disciplinary action removing a student from a residence hall will result in dismissal from International Summer in NYC without refund. Curfew - Students must be checked in at their residence hall by p.m. Sunday through Thursday, and a.m. on Friday and Saturday. By 1.00 a.m., students must be in their designated rooms. Program Assistants (P.A.s) will monitor the residence hall at these times. No exceptions or requests to extend curfew will be accepted unless the student is on a university-sponsored event. Students are not allowed to have guests in their residence halls, including family members and other students. Visitors will not be permitted past residence hall security and must meet residential students in the building lobby. Students will not be allowed to sleep over in other student rooms. Continued on next page

5 One of the greatest benefits of International Summer in NYC is the opportunity to experience life in New York City. The city has much to offer students, and students in International Summer in NYC will have opportunities to see different neighborhoods and sites under supervision of staff on program-sponsored excursions. New York University, however, does not have an enclosed campus. Students are advised to stay within close proximity of the Washington Square campus which is patrolled and serviced by the University s Public Safety officers. Students who choose to leave the main campus area at any time should understand that the farther they are from the main campus area, the more difficult it is for International Summer in NYC staff to assist them should they need assistance. Students and their parents/guardians should discuss and decide upon appropriate boundaries and guidelines for travel off campus while attending International Summer in NYC. Health and Wellness Support: International Summer in NYC is an intensive educational experience in which students will face academic and personal challenges that allow them numerous opportunities for self-discovery and growth. The experience may present potential stressors as well. Therefore, students and families are responsible for arranging for the support of medical or mental health professionals, as needed, prior to the start of the program. Statement on Ethics and Community Responsibility: NYU is committed to offering each student a meaningful experience. International Summer in NYC expects all students to understand the difference between acceptable and unacceptable behavior and to be responsible for their actions. Students may not engage in disrespectful, exclusionary, discriminatory, or abusive behavior that disrupts and/or compromises the learning experience of others. Prohibited behavior includes, but is not limited to: (a) community/social misconduct such as abusive use of social networking sites, verbal abuse, threats to injure or harm another or oneself, discrimination, or harassment; (b) academic misconduct such as lateness, disrupting another s work, cheating, or plagiarizing; and (c) program misconduct such as breaking curfew or any other rules or policies applicable to International Summer in NYC. International Summer in NYC staff reserve the right to judge the severity of any misconduct and to determine appropriate disciplinary actions/consequences. Policy on Substance Abuse: The possession or use of cigarettes and other tobacco products by students is strictly prohibited, regardless of the age of the student. The possession or use of alcohol by students is strictly prohibited. The possession or illegal use of a controlled substance or the possession of related paraphernalia by students is strictly prohibited. Smoking, consuming alcohol, illegal drug use, and the use of other abusive substances (e.g. unprescribed medications) are strictly prohibited at any time during International Summer in NYC and at any location on or off campus. Violations of this policy are grounds for dismissal from International Summer in NYC without refund. Discriminatory Harassment: New York University and the American Language Institute s Mastering English: International Summer in NYC are committed to maintaining a learning and working environment that is free of bias, prejudice, and harassment an environment that supports, nurtures, and rewards educational advancement on the basis of ability and performance. Harassment based upon race, gender, gender identity or expression, color, religion, age, national origin, ethnicity, disability, veteran or military status, sexual orientation, marital status, citizenship status, or any other legally protected basis is prohibited and undermines the character and purpose of International Summer in NYC. Any form of such harassment will not be tolerated. NYU Policy on Sexual Harassment: New York University and the American Language Institute s Mastering English: International Summer in NYC are committed to maintaining a safe learning environment that is free of acts of violence, harassment, and other forms of sexual misconduct that undermine the character and purpose of the University and to creating a campus and program climate that supports, nurtures, and rewards educational advancement on the basis of ability and performance. All students are subject to this policy and also are encouraged to report any incidents of sexual assault or harassment of which they become aware that compromise the well-being of an individual or the International Summer in NYC community. Disciplinary Processes: American Language Institute s Mastering English: International Summer in NYC has a zero tolerance policy with respect to the possession or use of cigarettes, alcohol, and illegal drugs and substances (including paraphernalia). Any student determined to have violated these policies will be immediately dismissed from International Summer in NYC without refund. All other policy violations will be addressed in accordance with International Summer in NYC adjudication processes set forth in the International Summer in NYC Program Handbook, and may result in a variety of sanctions depending upon the circumstances of the violation ranging from a warning to dismissal from International Summer in NYC without refund. It is important to note that students found present while a violation is occurring may be subject to disciplinary action along with the principle violator(s). Continued on next page

6 Confidentiality and Parent/Guardian Notification: The federal Family Educational Rights and Privacy Act of 1974 (FERPA) establishes standards concerning the privacy of student education records and the rights of students to inspect and review their education records. As enrolled students in a post-secondary institution, International Summer in NYC students are entitled to the protection afforded them under FERPA, and the right of access to educational records belongs to the student no matter the legal age or status as a minor. Students may elect to sign a Consent to Disclosure of Student Information form, available online in the International Summer in NYC Program Handbook, to permit the release of information to their parents or guardians about the student while in International Summer in NYC. Please be advised, however, that FERPA allows International Summer in NYC to notify the parents or guardians of a student when there is a significant threat to a student s health and safety or if a student has violated a University or International Summer in NYC rule or policy or public law concerning alcohol or another controlled substance. The decision to notify parents or guardians in such situations will be made according to the professional judgment of appropriate staff and does not require prior consent of the student. Students may or may not be consulted in the notification process.

7 2015 American Language Institute s Mastering English: International Summer in NYC Contract My signature below indicates that I have read, understood, and agree to the terms of American Language Institute s Mastering English: International Summer in NYC Contract (the Contract ) and rules and policies governing the program set forth in the Contract and online in the International Summer in NYC Handbook. I understand that violation of these rules and policies may lead to disciplinary action to be determined by senior program staff, including, without limitation, dismissal from American Language Institute s Mastering English: International Summer in NYC without refund of tuition or fees. Student Printed Name Student Signature (to electronically sign in Adobe, select sign in above toolbar) Parent or Guardian Printed Name Parent or Guardian Signature (to electronically sign in Adobe, select sign in above toolbar) Please check: I am attending International Summer in NYC as a residential student. I am attending International Summer in NYC as a commuter student.

8 American Language Institute s Mastering English: International Summer in NYC Emergency Contact Form Please print clearly and list emergency contacts that can be reached 24 hours/day, 7 days/week. Student Name Section I Personal Information 1) Student 2) Where will you be living this summer? I am a residential student and will be living on-campus: (Skip to Section II) I am commuter student and will be living at the address below: Address (No. and Street): Apartment No.: City: State: Zip Code: 3) With whom will you be living? Name: Relationship to Student: Home Phone: ( ) Alternate Phone: ( ) Section II Emergency Contact Information Emergency Contact 1 Name: Relationship to Student: Phone: Address: Emergency Contact 2 Name: Relationship to Student: Phone: Address:

9 American Language Institute s Mastering English: International Summer in NYC Acknowledgment of Risk and Release and Waiver of Liability Form As parent or legal guardian of the child whose name appears below, I acknowledge that there are certain risks inherent in my child s participation in the Mastering English: International Summer in NYC ( International Summer in NYC ) which will take place from July 5 25 or July 26 August 15, These risks include, without limitation, risks associated with travel to, from, and in and around New York City and my child s participation in supervised and unsupervised activities while at NYU. I also acknowledge that any questions I or my child have about activities or travel related to International Summer in NYC can be addressed to representatives of New York University (the University ). I agree that I will inform an appropriate representative of the University of any special information regarding the health, or physical or mental condition of my child that may be relevant to my child s participation in American Language Institute s Mastering English: International Summer in NYC In consideration for permitting my child to participate in International Summer in NYC, I hereby agree: (a) to release and discharge the University from any liability or responsibility for any personal or bodily injury (including death), and for any damage to or loss of property, however caused, that my child or I suffer as a result of or in connection with my child s participation in International Summer in NYC or any travel related to International Summer in NYC, including, without being limited to, any injury, loss, or damage resulting from, arising out of, or occurring in connection with the negligent acts or omissions of members of the faculty or staff or other employees, agents or servants of the University; and (b) not to raise any claim or institute any legal action or proceeding, on my behalf or on behalf of my child, against the University for any cause of action that may result from or arise out of or in connection with my child s participation in International Summer in NYC or any travel related to International Summer in NYC, for any personal or bodily injury (including death) to my child, including, without being limited to, injury, loss, or damage that may result from or arise out of or in connection with the negligent acts or omissions of members of the faculty or staff or other employees, agents, or servants of the University. All references to the University in this form will include, and all provisions of this form will inure to the benefit of, the University s trustees, officers, employees, agents, servants, and representatives. This acknowledgment of risk and release and waiver of liability are governed by and will be construed in accordance with the laws of the State of New York without regard to principles of conflicts of law. I agree that I will submit to the exclusive jurisdiction of the federal and state courts located in New York County, New York State, for the resolution of all disputes arising hereunder or relating hereto, regardless of the place of execution of this form. Student Name (print) Parent/Legal Guardian (print) Parent/Legal Guardian (signature) (to electronically sign in Adobe, select Sign in above toolbar)