Shasta College Indonesia Science Expedition Summer 2016

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1 Shasta College Global Education Application Form Shasta College Indonesia Science Expedition Summer 2016 Thank you for your interest in our Summer 2016 Shasta College Indonesia Science Expedition Program! This letter outlines the program, costs, and application process. We will be in the field from June 29 - July 12 with 1 to 2 days tacked on to each end for travel. This expedition is part of a mandatory Field Biology and Field Geography (Physical/Cultural) course combination that will include online study before and after our time in Indonesia, in-field activities in Indonesia, and a couple face-to-face class meetings (TBA) at the main Shasta College campus in Redding, California before and after our time in Indonesia. As a member of the Shasta College Summer 2016 Indonesia Science Expedition Program, you will have the opportunity to apply for scholarships, utilize Shasta College bus transportation to and from the airport at no additional cost, sign up for low-cost group SCUBA certification at Shasta College, and be covered by additional traveler s insurance as well as have the potential to be involved in fundraising activities and PR events! There is a club on campus that you can join, the Shasta College Global Expeditions Club, which is involved with fundraising for the expedition, as well as offering regular outdoor activities such as backpacking and hiking, to get you into the outdoors and prepped for the science expedition! The total cost* for this expedition program will range between $3,800 and 4,500 depending on the number of students who sign up, the price of flights, the price of Shasta College credits/tuition*, whether you get scuba certified before leaving (this would be organized with a local company at a group rate here in town or if you don't want to scuba dive, snorkeling will also be an option), and whether you sign up for canopy access training. We will accept students on a first-come, first-served basis, so please do not delay as the program may fill quickly. Only an application form with a deposit check of $250 will reserve your space in the program. To complete this application process, follow these steps: 1) Complete this Shasta College Global Education Application. Fill out the information on the application form (Sections 1-8) as completely as possible, write legibly, and be sure to include contact numbers, your name as it appears (or will appear) on your passport and sign all contacts and releases. If you do not have passport number yet, that can be filled in later, but it will need to be completed no later than 60 days prior to departure. 2) Submit your initial $250 deposit check made out to Shasta College (with Indonesia 2016 in the memo section of the check) along with this Application Form to Kristen Ruano in the Office of Instruction (room 115) in the Shasta College Administration Building (100 building). The deposit check is non-refundable once you are accepted to the program, unless the college admits someone from the wait list to take your spot. Once you have paid your deposit and your application form has been reviewed and verified, you will be connected with Operation Wallacea (OpWall) whom we are working with for logistics and research connections and to whom you will be submitting subsequent payments my mail or by debit or credit card. 3) Apply to Shasta College unless you are already an admitted student (you will need to know your Shasta College student ID number). To apply to Shasta College, go to the Shasta College website ( click on Admissions, then on Apply for Admission, and follow the directions. 1

2 a) High School students need to complete a Concurrent Enrollment form (this does not apply if you are graduating prior to your Shasta College course start date) b) All applicants are strongly encouraged to register for Financial Aid as many forms of aid exist and may be applied to the expedition courses, not to mention the scholarship opportunities*. 4) Enroll in the Summer 2016 expedition courses when they open in the spring. High school students and college students who have BOG fee waivers will only pay about $40 in student activity fees. 5) Consider joining the Global Expeditions Club! Contact the club faculty representatives, Susannah Johnson- Fulton (sfulton@shastacollege.edu), Dan Scollon (dscollon@shastacollege.edu), or Randy Reed (rreed@shstacollege.edu) for more information! *High school students and college students who have BOG fee waivers will only pay about $40 in student activity fees. Substantial scholarships are available, there is a college club involved in fundraising, and since the expedition is part of a college course, financial aid can be used towards it. The total amount will be split into payments with the first payment being the deposit of $250. After receiving your completed application and deposit, the Shasta College Global Education Program will inform you of your acceptance into the program. Please note that there will be a couple mandatory orientation/course meetings during the spring and early summer before the expedition to help you prepare for this program abroad and we will meet after the trip, as well, to complete the course. These meeting times will be announced at a later date. We will strive to answer any questions you may have concerning our Global Education program or will refer you to the appropriate resources. Studying abroad can be a unique and significant experience in your educational career and result in fond memories, new friendships, and appreciation for our world and the diversities it encompasses, however, it does require preparation in these coming months, so be sure to read everything you are given, ask questions and respond to our s. Shasta College is committed to providing a safe, rewarding and academically meaningful experience. The course materials connected with this expedition program are designed to integrate with the materials and field experiences presented by OpWall for maximum benefit to you. For this experience to be successful, you should be prepared to commit time to fully participating in pre-trip and post-trip course readings, discussions, and related activities. We are here to serve you as you prepare for an experience of a lifetime. Sincerely, Susannah Johnson-Fulton and Randy Reed Shasta College Global Education Program Coordinators And Susannah Johnson-Fulton and Dan Scollon Indonesia Expedition Instructors Contact Information: Susannah Johnson-Fulton (530) sfulton@shstacollege.edu Randy Reed (530) rreed@shastacollege.edu Dan Scollon (530) dscollon@shastacollege.edu 2

3 Shasta College Global EducationApplication Form Indonesia Summer 2016 Section 1: Personal Information Full Name of Student as it appears (or will be appear) on your passport: Mailing Address: Home phone: ( ) - Cell phone: ( ) - Do you receive texts? Primary address: Are you in high school? Yes or No If yes, which high school? Shasta College Student ID # (if you don t have this yet, it can be added later): I am a citizen of: Date of Birth: / / I was born in: Male Female Passport # (if you don t have this yet, it must be added later): Passport Expiration Date*: *Please note that your passport must have at least 6 months validity at the time of your arrival into Indonesia. Failure to have at least 6 months validity on your passport will ensure denial of entry into Indonesia. Section 2: Mandatory Course Registration and Involvement Students must commit to registering for the Indonesia Study Abroad Program course combination, which includes Field Biology (BIOL 12) 4 units, Field Geography (Physical) (GEOG 2A) 1 unit, and Field Geography (Cultural) (GEOG 2B) 1 unit, for a total of 6 units and must commit to remaining an active participant for the entire trip and course. This includes but is not limited to attending all class meetings on time before, during, and after the expedition, fully participating in classes, attending all field presentations, and being on time for transfers and departures. I understand that it is mandatory that I register for and remain actively involved in the course combination for the entire designated summer session. Failure to do so will result in my removal from this expedition program, a failing grade, loss of Shasta College arranged transportation, and return of all scholarship monies. Student signature: Date : Parent signature (if student is under 18): Date: 3

4 Section 3: Your Interest Why do you want to be a part of this study abroad program to Indonesia? Section 4: Your Comfort and Safety List any information that would help as we plan housing, food, etc. (allergies, health problems, fears, etc.) Notice of Physical Activity and Health Considerations: In order to truly enjoy and get the most out of this experience, students should be physically prepared for easy to moderate to difficult hiking conditions, be able to backpack for up to 4-5 hours in warm, humid conditions, and be able to swim in an open water environment. It is recommended that you begin a fitness routine as soon as you can to be prepared. The Shasta College Global Expeditions Club will organize multiple hiking trips, including at least two backpacking trips to offer assist with this endeavor. As mentioned, this course will take you on easy to moderately strenuous hikes and/or dives at differing elevations and/or depths (dependent on PADI certification) during variable weather and/or water conditions, each of which may pose a health risk to individuals with certain ailments. The undertaking of any physical activity should only occur after careful consideration of the type of activity, its inherent risks and potentially should include consultation with and approval from, a doctor. After review of the types of activities related to this study abroad expedition, I understand there are inherent risks should I choose to participate. Section 5: Financial Situation Is your participation contingent upon you receiving financial aid*? Yes No If yes, how much is required? Will you be applying for financial aid? Yes No *Please note: other than assistance with fundraising and opportunities to apply for substantial scholarships, there is no specific financial aid for this program. If you currently receive financial aid you may use it for this educational program. Check with a financial aid counselor as soon as possible to see if you qualify for aid. Follow this link to register with Shasta College Financial Aid: 4

5 Section 6: Shasta College Global Education Code of Conduct Students are expected to conform to all Shasta College rules, Board Policies and Administrative Regulations including, but not limited to the Student Conduct as set forth in the Shasta College Catalog (Chapter 7). Further, the undersigned shall respect the laws and the people while in a foreign country and shall comply with the directions of all teachers and representatives of the program. Any egregious or repetitive infraction of these standards may lead to disciplinary action by Shasta College. Note that Chapter 7 of the Shasta College catalog applies to all Shasta College students and the following Shasta College Global Education Code of Conduct polices noted here are additional and apply to all participants in this study abroad program. Please access Chapter 7 of the Shasta College catalog here to review Student Code of Conduct: Study Abroad Code of Conduct (in addition to Chapter 7of the Shasta College catalog): I shall be aware that I am a guest in a foreign country and shall adjust my behavior to reveal respect for my hosts. I am aware that this is a college study program and I must participate in the academic portion of the program. Failure to do so will result in my removal from the program and return to the USA at my own expense. I shall observe the governing laws of both the host country and to those of Shasta College, as this is a travel-study program. In the host country I shall obey and respect official authorities and persons performing the duties of their employment (e.g. police, bus drivers, tour guides, hotel managers, restaurant waiters, etc., including Shasta College professors.) I understand that any infraction of the standards as stated above or within Chapter 7 of the Shasta College catalog may lead to disciplinary action by the college and/or the director of the program. Major or repeated disregard of these policies as determined by the program instructors and director may lead to expulsion from the program and forced return to the United States at my own expense. Student signature: Date : Parent signature (if student is under 18): Date: 5

6 Section 7: Shasta College Travel Waiver I understand and acknowledge that participation in this activity is completely voluntary and, as such, is not required by the Shasta- Tehama-Trinity Joint Community College District (STTJCCD). I hereby agree to assume liability and responsibility for any and all potential risks that may be associated with participation in this activity, and insofar as the law allows, I hereby hold the STTJCCD, its officers, agents and employees harmless from any and all liability or claims arising out of, or in connection with, my participation in this activity. (Section 55220, Title 5, California Code of Regulations). In the event of any illness or injury, I hereby consent to whatever x-ray, examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care from a licensed physician and/or surgeon as deemed necessary for my safety and welfare. It is understood that the resulting expenses will be my responsibility. Student Name (Print) Student Signature Parent/Guardian Signature (reguired if student is under 18 years old) Phone Date of Birth (only if under 18) Today s Date IN THE EVENT OF ILLNESS OR INJURY, PLEASE NOTIFY: Name Address Phone If there are any special medical problems, please attach a description of the restrictions or medical alerts to this sheet. 6

7 Section 8: Public Relations Release Form I have voluntarily agreed, without compensation of any kind, to appear or allow my art work or image to appear in any print, film, digital likeness or videotape produced by the Shasta-Tehama-Trinity Joint Community College District. The Shasta-Tehama-Trinity Joint Community College District shall have the right and may grant to others the right to disseminate, print, alter and publish my name, likeness and biographical material, in connection with any publicity and promotion of the print, film, digital likeness, videotape or art work, except for the direct endorsement of any product. I hereby release and discharge the Shasta-Tehama-Trinity Joint Community College District and its respective agents, employees, successors, assigns and licensees from any and all claims, liabilities and obligations of any kind of nature that may arise from my appearance or participation or art work incorporated in the print, film, digital likeness or videotape of any exhibition thereof. I agree that the Shasta-Tehama-Trinity Joint Community College District has no obligation to exhibit or televise my performance or art work or otherwise use my likeness or art work in its print, film, digital or videotape. Signature Signature of Parent/Guardian if under 18 yrs. Address: Telephone number: Print Name: Date: City State Zip Code Description of activity, Event or Publication: 7